Active NPI
Leann R Clark, LMT
- Massage Therapist
- Woodland Park, CO
National Provider Identifier
1114245701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 9128
- Practice address
- 216 W. Midland Avenue
Woodland Park, CO 80863 - Phone
- (719) 687-2599
- Fax
- (719) 687-3812
- NPI assigned
- May 7, 2010
- Last updated
- May 7, 2010
- Sex
- Female
- Sole proprietor
- No
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 | 9128 | CO | Primary |
Addresses
Primary practice location
216 W. Midland Avenue
Woodland Park, CO 80863
Mailing address
PO Box 5796
Woodland Park, CO 80866-5796
Phone (719) 687-2599
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 |
|---|---|---|---|
| 9128 | CO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thunder Mountain Holdings, LLC | Massage Therapist | Past | 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": "1273190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273190400000",
"number": "1114245701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5796",
"city": "WOODLAND PARK",
"state": "CO",
"postal_code": "808665796",
"telephone_number": "719-687-2599",
"fax_number": "719-687-3812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 W. MIDLAND AVENUE",
"city": "WOODLAND PARK",
"state": "CO",
"postal_code": "80863",
"telephone_number": "719-687-2599",
"fax_number": "719-687-3812"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "LEANN",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-07",
"last_updated": "2010-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "9128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodland Park, CO
- Central Colorado Counseling
- Centura Ventures, LLC (CS Langstaff Brown PT)
- Casie Chen, MD
- Christopher B Estep (Ute Pass Psychological Consultation)
- Katherine Diane Clark, LPC
- Lonnie W. Clark, CRNA
- Brandy Cline, LPC
- Co Specialty Dental Services, PLLC
- Dana Lee Collins, L.P.C.
- Colorado Dental Orthodontist Practice, PLLC (Woodland Park Orthodontics)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.