OrganizationActive
Massage Revolution
NPI 1104253285 · Massage Therapist · Jackson, MS
Provider details
- NPI number
- 1104253285
- Entity type
- Organization
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Abraham Santa Cruz, Operations Manager(601) 918-1853
- License
- 2027 (MS)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
210 E Capitol St
Suite M-142
Jackson, MS 39201-2306
Phone: (601) 918-1853
Street-level locationGet directions
Mailing address
210 E Capitol St
Jackson, MS 39201-2306
Other names (DBA / former)
- Former legal business name
- Massage Revolution, LLC
Registry dates
- Enumerated
- 2013-10-03
- Last updated
- 2013-10-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.