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JACKSON SPA LLC
NPI 1932089091
Massage Therapist in Jackson, TN

Active since September 08, 2025
31 WILEY PARKER RD STE H, JACKSON, TN 38305 Get Directions Write a Review

NPPES record last updated: September 8, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jackson Spa Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACKSON SPA LLC (NPI 1932089091), doing business as Jackson Massage And Day Spa, is a healthcare organization registered as a massage therapist in Jackson, Tennessee and active in the NPI registry since September 2025. The organization lists Kellie Leigh Wallace-wilding, Owner, as its authorized official.

NPPES Registry Identity

NPI1932089091
Entity TypeOrganization
Primary Taxonomy225700000X
Legal Business NameJACKSON SPA LLC
Location Address31 WILEY PARKER RD STE HJackson, TN 38305-5806
Mailing Address31 Wiley Parker Rd Ste HJackson, TN 38305-5806 · 0
Phone0
Organization SubpartNo
Authorized OfficialKellie Leigh Wallace-wildingOwner · (901) 229-1744
Enumeration DateSeptember 8, 2025
NPPES CertifiedSeptember 8, 2025
✔ NPI 1932089091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Other Names 3

Doing Business AsJackson Massage And Day Spa
Doing Business AsCryosculpt
Other NameReke

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICIA ANN MOORE MT
Massage Therapist
31 WILEY PARKER RD STE H
JACKSON, TN 38305
Madison County (731) 660-0900
TYLER ALLEN LMT
Massage Therapist
31 WILEY PARKER RD STE H
JACKSON, TN 38305
Madison County (731) 660-0900
JODI ROMERO
Massage Therapist
31 WILEY PARKER RD STE H
JACKSON, TN 38305
Madison County (731) 660-0900

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackson Spa LLC's NPI number?

The NPI number for Jackson Spa LLC is 1932089091. It was assigned to this organization in the NPPES registry on September 8, 2025. The provider is doing business as Jackson Massage and Day Spa and cryosculpt. The provider is also known as reke.

Where is Jackson Spa LLC located?

Jackson Spa LLC is located at 31 Wiley Parker Rd Ste H, Jackson, TN 38305.

What is Jackson Spa LLC's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Jackson Spa LLC was last updated on September 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.