Lisa Widdowson, LMT, CTT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2595 Issued in NE

Practice address

7200 S 84TH St Ste 140
La Vista, NE 68128-2115

Phone

(402) 915-1590

Fax

(402) 939-0614

NPI assigned

Jan 7, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

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": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1114490604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 S 75TH ST",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681282220",
            "telephone_number": "402-590-9384",
            "fax_number": "402-939-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 S 84TH ST STE 140",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681282115",
            "telephone_number": "402-915-1590",
            "fax_number": "402-939-0614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDOWSON",
        "first_name": "LISA",
        "credential": "LMT, CTT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "NE",
            "license": "G01-370662",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NE",
            "license": "2595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in La Vista, NE
• Providers in La Vista, NE by specialty
• Massage Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; 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.