Leo Dillon Pettit, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

133088 Issued in AK

Practice address

10823 E Palmer Wasilla Hwy Ste 4
Palmer, AK 99645-9498

Phone

(907) 707-3847

NPI assigned

Jul 15, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Alaskans Relax-Zen

  • Massage Therapist
  • Palmer, AK
  • NPI 1568156438
  NPD Authorized official
• Birch Medical Billing, LLC

  dba Birch Medical Billing

  • Clinic/Center
  • Palmer, AK
  • NPI 1609704055
  NPD Authorized official

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

{
    "created_epoch": "1531612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1003392812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10823 E PALMER WASILLA HWY STE 4",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996459498",
            "telephone_number": "907-707-3847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10823 E PALMER WASILLA HWY STE 4",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996459498",
            "telephone_number": "907-707-3847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "LEO",
        "middle_name": "DILLON",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-15",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "133088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerod Perron
• Emmali Jean Peters
• Jennifer Hill Peters, OTR/L
• Camylle Peterson
• Kyrin Peterson
• Monica Pettit
• Kylee Phillips
• Playful Journeys, Inc (Playful Journeys Counseling Center)
• Playful Journeys, Inc.
• Marlana M. Plumley

• Massage Therapist in Palmer, AK
• Providers in Palmer, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.