Phyllis V Jordan, LMT, RMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

R02519 Issued in MD

Practice address

263 W Patrick St
Frederick, MD 21701-6910

Phone

(301) 388-5237

NPI assigned

Dec 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1962007096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 E A ST APT 1",
            "city": "BRUNSWICK",
            "state": "MD",
            "postal_code": "217161473",
            "telephone_number": "240-578-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 W PATRICK ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016910",
            "telephone_number": "301-388-5237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "236 W Patrick Street",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "21701",
            "country_code": "US",
            "telephone_number": "301-388-5237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "PHYLLIS",
        "middle_name": "V",
        "credential": "LMT, RMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019015415",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MD",
            "license": "R02519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chantal Jora
• Chelsea Jordan, LMSW
• Jennifer Leslie Jordan, LCSW-C
• Jessica Marie Jordan, PHARMD, BCGP
• Margaret A. Jordan, LGPC
• Jose C. Muniz, MD, PA
• Claire Anita Joseph, RN
• Guy- Ronald Joseph, MD
• Akanksha Gaur Joshi, DMD
• James Matthew Judge

• Massage Therapist in Frederick, MD
• Providers in Frederick, MD by specialty
• Massage Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.