Active NPI
Lisa Labotte
- Massage Therapist
- Marion, IL
National Provider Identifier
1053709519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227.006986
- Practice address
- 900 W White St
Marion, IL 62959-1855 - Phone
- (618) 889-3220
- Fax
- (618) 969-7174
- NPI assigned
- Jan 6, 2015
- Last updated
- Jan 6, 2015
- 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 | 227.006986 | IL | Primary |
Addresses
Primary practice location
900 W White St
Marion, IL 62959-1855
Mailing address
900 W White St
Marion, IL 62959-1855
Phone (618) 889-3220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 227.006986 | Other | IL | ILLINOIS DEPARTMENT OF FEDERAL AND PROFESSIONAL REGULATION |
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 |
|---|---|---|---|
| 227.006986 | IL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wharton Enterprises LTD | Massage Therapist | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420502400000",
"number": "1053709519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 W WHITE ST",
"city": "MARION",
"state": "IL",
"postal_code": "629591855",
"telephone_number": "618-889-3220",
"fax_number": "618-969-7174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 W WHITE ST",
"city": "MARION",
"state": "IL",
"postal_code": "629591855",
"telephone_number": "618-889-3220",
"fax_number": "618-969-7174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LABOTTE",
"first_name": "LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-06",
"last_updated": "2015-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227.006986",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILLINOIS DEPARTMENT OF FEDERAL AND PROFESSIONAL REGULATION",
"identifier": "227.006986",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.