Jacqueline Marie Deyoe, LMT

Key facts

NPI

1982483129

Entity type

Individual (NPI type 1)

Primary specialty

Massage Therapist 225700000X

License

260408 (KY)

Practice address

830 Monmouth St
Newport, KY 41071-1821

Phone

(859) 322-8135

NPI assigned

Sep 26, 2023

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 26, 2023.

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1982483129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 HAWTHORNE AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452052225",
            "telephone_number": "859-322-8135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 MONMOUTH ST",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410711821",
            "telephone_number": "859-322-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYOE",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "260408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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