Individual provider Active NPI

Jenna Lynn Peterson, LMT

  • Massage Therapist
  • Chandler, AZ
National Provider Identifier
1942556766
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT-16104 Issued in AZ
Practice address
325 N Alma School Rd Ste 3
Chandler, AZ 85224-4379
Phone
(260) 413-4757
NPI assigned
Jul 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT-16104 AZ Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X

Addresses

Primary practice location

325 N Alma School Rd Ste 3
Chandler, AZ 85224-4379

Mailing address

533 W Guadalupe Rd Unit 2077
Mesa, AZ 85210-7784
Phone (260) 413-4757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MT-16104AZMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1942556766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 W GUADALUPE RD UNIT 2077",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852107784",
            "telephone_number": "260-413-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N ALMA SCHOOL RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244379",
            "telephone_number": "260-413-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JENNA",
        "middle_name": "LYNN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-16104",
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.