Active NPI
Lara Chilton, CMT
- Massage Therapist
- Indianapolis, IN
National Provider Identifier
1104342732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT21104206
- Practice address
- 2250 W 86TH St Ste 100
Indianapolis, IN 46260-1965 - Phone
- (317) 876-7826
- NPI assigned
- Aug 15, 2017
- Last updated
- Aug 15, 2017
- 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 | MT21104206 | IN | Primary |
Addresses
Primary practice location
2250 W 86TH St Ste 100
Indianapolis, IN 46260-1965
Mailing address
5909 Nash LN
Speedway, IN 46224-5310
Phone (317) 441-3824
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 |
|---|---|---|---|
| MT21104206 | IN | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502755200000",
"number": "1104342732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5909 NASH LN",
"city": "SPEEDWAY",
"state": "IN",
"postal_code": "462245310",
"telephone_number": "317-441-3824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2250 W 86TH ST STE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462601965",
"telephone_number": "317-876-7826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILTON",
"first_name": "LARA",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-15",
"last_updated": "2017-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IN",
"license": "MT21104206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.