Individual provider Active NPI

Lucinda Rawls

  • Massage Therapist
  • Montgomery, AL
National Provider Identifier
1114782059
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
5911 Monticello Dr Ste B
Montgomery, AL 36117-1940
Phone
(629) 279-5270
NPI assigned
Feb 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mastectomy Fitter 224900000X C42148 AL
Massage Therapist 225700000X AL Primary

Addresses

Primary practice location

5911 Monticello Dr Ste B
Montgomery, AL 36117-1940

Mailing address

5911 Monticello Dr Ste B
Montgomery, AL 36117-1940
Phone (629) 279-5270

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

LicenseStateTypeSpecialty
C42148ALMDMastectomy Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Mastectomy Vendor LLC Mastectomy Fitter CurrentSince Feb 25, 2024 Accepting new patients

Locations

5911 Monticello Dr
Ste B
Montgomery, AL 36117
Phone (334) 676-2797

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1114782059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5911 MONTICELLO DR STE B",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361171940",
            "telephone_number": "629-279-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5911 MONTICELLO DR STE B",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361171940",
            "telephone_number": "629-279-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLS",
        "first_name": "LUCINDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224900000X",
            "taxonomy_group": "",
            "desc": "Mastectomy Fitter",
            "state": "AL",
            "license": "C42148",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.