Active NPI
Lisa Marie Wourms
- Massage Therapist
- Fargo, ND
National Provider Identifier
1104129527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 1144
- Practice address
- 1121 Westrac Dr S Ste 102
Fargo, ND 58103-2385 - Phone
- (701) 297-8191
- NPI assigned
- Dec 7, 2010
- 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 | 1144 | ND | Primary |
Addresses
Primary practice location
1121 Westrac Dr S Ste 102
Fargo, ND 58103-2385
Mailing address
1403 3Rd Ave N
Moorhead, MN 56560-2238
Phone (320) 760-4342
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 |
|---|---|---|---|
| 1144 | ND | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| All Bright Chiropractic PLLC | Past | Accepting new patients | |
| Elite Therapeutic Massage LLC | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Chiropractor
- Fargo, ND
- NPI 1376009720
-
- Massage Therapist
- Fargo, ND
- NPI 1700611571
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1104129527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1403 3RD AVE N",
"city": "MOORHEAD",
"state": "MN",
"postal_code": "565602238",
"telephone_number": "320-760-4342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 WESTRAC DR S STE 102",
"city": "FARGO",
"state": "ND",
"postal_code": "581032385",
"telephone_number": "701-297-8191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOURMS",
"first_name": "LISA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-07",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ND",
"license": "1144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.