Active NPI
Jennifer Rita Raimondi, LMT
- Massage Therapist
- Providence, RI
National Provider Identifier
1992063168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT01476
- Practice address
- 376 West Fountain Street
Providence, RI 02903 - Phone
- (401) 274-2225
- Fax
- (401) 274-2228
- NPI assigned
- Apr 25, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT01476 | RI | Primary |
Addresses
Primary practice location
376 West Fountain Street
Providence, RI 02903
Mailing address
376 West Fountain Street
Providence, RI 02903
Phone (401) 274-2225
Other practice location 1
379 Broadway
West Side Wellness
Providence, RI 02909
Phone (401) 837-6204
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
| License | State | Type | Specialty |
|---|---|---|---|
| MT01476 | RI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Side Wellness, LLC | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Massage Therapist
- Province, RI
- NPI 1417215690
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508457600000",
"number": "1992063168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "376 WEST FOUNTAIN STREET",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02903",
"telephone_number": "401-274-2225",
"fax_number": "401-274-2228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "376 WEST FOUNTAIN STREET",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02903",
"telephone_number": "401-274-2225",
"fax_number": "401-274-2228"
}
],
"practiceLocations": [
{
"address_1": "379 Broadway",
"address_2": "West Side Wellness",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "02909",
"country_code": "US",
"telephone_number": "401-837-6204",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAIMONDI",
"first_name": "JENNIFER",
"middle_name": "RITA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-25",
"last_updated": "2017-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "RI",
"license": "MT01476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.