Jody Forcum, MMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

6561 Issued in AR

Practice address

1120 S Walton Blvd Ste 104
Bentonville, AR 72712-0075

Phone

(479) 271-8300

NPI assigned

Sep 1, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1902113665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 S 9TH ST APT 213",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727586327",
            "telephone_number": "794-295-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S WALTON BLVD STE 104",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727120075",
            "telephone_number": "479-271-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "198 W Marydale Ave",
            "address_purpose": "LOCATION",
            "city": "Soldotna",
            "state": "AK",
            "postal_code": "996697501",
            "country_code": "US",
            "telephone_number": "907-262-7977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORCUM",
        "first_name": "JODY",
        "name_prefix": "Mrs.",
        "credential": "MMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AR",
            "license": "6561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Massage Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.