Individual provider Active NPI

Jill Fieldman, CMT

  • Massage Therapist
  • Playa del Rey, CA
National Provider Identifier
1972155067
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
75782 Issued in CA
Practice address
408 Pershing Dr
Playa del Rey, CA 90293-7742
Phone
(843) 450-7301
NPI assigned
Jul 10, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 75782 CA Primary

Addresses

Primary practice location

408 Pershing Dr
Playa del Rey, CA 90293-7742

Mailing address

408 Pershing Dr
Playa del Rey, CA 90293-7742
Phone (843) 450-7301

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
75782CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1972155067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 PERSHING DR",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937742",
            "telephone_number": "843-450-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 PERSHING DR",
            "city": "PLAYA DEL REY",
            "state": "CA",
            "postal_code": "902937742",
            "telephone_number": "843-450-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDMAN",
        "first_name": "JILL",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "75782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Playa del Rey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.