Individual provider Active NPI

Jennifer Lyn Wilkicki, LMT

  • Massage Therapist
  • Cranston, RI
National Provider Identifier
1982045399
Registry record updated Jul 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT01904 Issued in RI
Practice address
51 Sockanosset Cross Rd
Suite 204
Cranston, RI 02920-5536
Phone
(401) 935-3549
NPI assigned
Jul 14, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2013

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 MT01904 RI Primary

Addresses

Primary practice location

51 Sockanosset Cross Rd
Suite 204
Cranston, RI 02920-5536

Mailing address

51 Sockanosset Cross Rd
Suite 204
Cranston, RI 02920-5536
Phone (401) 935-3549

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
MT01904RIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1373760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373760000000",
    "number": "1982045399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 SOCKANOSSET CROSS RD",
            "address_2": "SUITE 204",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029205536",
            "telephone_number": "401-935-3549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SOCKANOSSET CROSS RD",
            "address_2": "SUITE 204",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029205536",
            "telephone_number": "401-935-3549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKICKI",
        "first_name": "JENNIFER",
        "middle_name": "LYN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-14",
        "last_updated": "2013-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "RI",
            "license": "MT01904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2013; 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.