Active NPI
Zhavanya Leigh Leib, LMT
- Massage Therapist
- Medford, OR
National Provider Identifier
1043784945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 18136
- Practice address
- 940 Ellendale Dr Ste 102
Medford, OR 97504-8216 - Phone
- (541) 210-5687
- NPI assigned
- Jan 15, 2019
- Sex
- Female
- 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 | 18136 | OR | Primary |
Addresses
Primary practice location
940 Ellendale Dr Ste 102
Medford, OR 97504-8216
Mailing address
502 Wagner Creek Rd
Talent, OR 97540-6728
Phone (541) 500-7184
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 |
|---|---|---|---|
| 18136 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Siskiyou Vital Medicine LLC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547510400000",
"number": "1043784945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 WAGNER CREEK RD",
"city": "TALENT",
"state": "OR",
"postal_code": "975406728",
"telephone_number": "541-500-7184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 ELLENDALE DR STE 102",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048216",
"telephone_number": "541-210-5687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIB",
"first_name": "ZHAVANYA",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-15",
"last_updated": "2019-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "OR",
"license": "18136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.