Active NPI
Lisa Anne Main
- Massage Therapist
- Le Roy, NY
National Provider Identifier
1013034305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 012286-1
- Practice address
- 15 Bank St
Leroy, NY 14482 - Phone
- (585) 768-1980
- NPI assigned
- Mar 23, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 012286-1 | NY | Primary |
Addresses
Primary practice location
15 Bank St
Leroy, NY 14482
Mailing address
15 Bank St
Leroy, NY 14482
Phone (585) 768-1980
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 |
|---|---|---|---|
| 012286-1 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013034305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 BANK ST",
"city": "LEROY",
"state": "NY",
"postal_code": "14482",
"telephone_number": "585-768-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 BANK ST",
"city": "LEROY",
"state": "NY",
"postal_code": "14482",
"telephone_number": "585-768-1980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAIN",
"first_name": "LISA",
"middle_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "012286-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Le Roy, NY
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.