Mary A Lange, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA0012657 Issued in FL

Practice address

210 Moody Blvd
Flagler Beach, FL 32136-3372

Phone

(386) 439-6933

Fax

(386) 439-6605

NPI assigned

Apr 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093837650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1853",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "321361853",
            "telephone_number": "386-439-6933",
            "fax_number": "386-439-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MOODY BLVD",
            "city": "FLAGLER BEACH",
            "state": "FL",
            "postal_code": "321363372",
            "telephone_number": "386-439-6933",
            "fax_number": "386-439-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA0012657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Leslie Johnson, D.D.S.
• Sarah Jones
• Charlotte Jung, PHARMD
• Ellen Kincaid, BCABA
• Kemp Bradley Kirk I, D.C.
• Linda S Lazear, LMT
• Richard Lehman, LMT
• Ellen Lemmon
• Adam Sidi Lemnouni, DC
• Sidi M Lemnouni, DC

• Massage Therapist in Flagler Beach, FL
• Providers in Flagler Beach, FL by specialty
• Massage Therapist in Florida

• 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.

Verify at the official NPI Registry.