Active NPI
Donna Jo Grant, LMT
- Massage Therapist
- Los Lunas, NM
National Provider Identifier
1114209004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 6926
- Practice address
- 1603 Main St SW
Los Lunas, NM 87031-8766 - Phone
- (505) 504-3861
- NPI assigned
- Sep 15, 2011
- Last updated
- Sep 15, 2011
- 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 | 6926 | NM | Primary |
Addresses
Primary practice location
1603 Main St SW
Los Lunas, NM 87031-8766
Mailing address
2 Berben Rd
Los Lunas, NM 87031-7113
Phone (505) 916-6708
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 |
|---|---|---|---|
| 6926 | NM | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1114209004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 BERBEN RD",
"city": "LOS LUNAS",
"state": "NM",
"postal_code": "870317113",
"telephone_number": "505-916-6708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1603 MAIN ST SW",
"city": "LOS LUNAS",
"state": "NM",
"postal_code": "870318766",
"telephone_number": "505-504-3861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "DONNA JO",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-15",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "6926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Lunas, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.