Active NPI
Daniel Lee Ledbetter, LMT
- Massage Therapist
- Roswell, NM
National Provider Identifier
1003954660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3528
- Practice address
- 216 W 1St St
Roswell, NM 88203-4602 - Phone
- (505) 625-5536
- NPI assigned
- Feb 2, 2007
- Sex
- Male
- 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 | 3528 | NM | Primary |
Addresses
Primary practice location
216 W 1St St
Roswell, NM 88203-4602
Mailing address
PO Box 204
Hagerman, NM 88232-0204
Phone (505) 625-5536
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00RL28 | Other | NM | BLUE CROSS BLUE SHIELD |
Other names 1
- Mr. D. Lee Ledbetter
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 |
|---|---|---|---|
| 3528 | NM | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003954660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 204",
"city": "HAGERMAN",
"state": "NM",
"postal_code": "882320204",
"telephone_number": "505-625-5536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 W 1ST ST",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882034602",
"telephone_number": "505-625-5536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEDBETTER",
"first_name": "DANIEL",
"middle_name": "LEE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "3528",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00RL28",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "D.",
"last_name": "LEDBETTER",
"middle_name": "LEE",
"prefix": "MR.",
"credential": "LMT",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.