Active NPI
Audrey Lynn Lovelace, LMBT 09629
- Massage Therapist
- Eden, NC
National Provider Identifier
1053193706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 09629
- Practice address
- 109 Twila LN
Eden, NC 27288-4339 - Phone
- (336) 589-0347
- NPI assigned
- Oct 17, 2023
- 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 | 09629 | NC | Primary |
Addresses
Primary practice location
109 Twila LN
Eden, NC 27288-4339
Mailing address
109 Twila LN
Eden, NC 27288-4339
Phone (336) 589-0347
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 |
|---|---|---|---|
| 09629 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697500800000",
"number": "1053193706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 TWILA LN",
"city": "EDEN",
"state": "NC",
"postal_code": "272884339",
"telephone_number": "336-589-0347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 TWILA LN",
"city": "EDEN",
"state": "NC",
"postal_code": "272884339",
"telephone_number": "336-589-0347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVELACE",
"first_name": "AUDREY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LMBT 09629",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-17",
"last_updated": "2023-10-17",
"certification_date": "2023-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "09629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.