Diane Michelle McCrummen, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA64792

Practice address

2501 Panfish Dr
Lake Wales, FL 33898-8838

Phone

(407) 600-5755

NPI assigned

May 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Diane Michelle Jenkins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1144965278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 PANFISH DR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338988838",
            "telephone_number": "407-600-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 PANFISH DR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338988838",
            "telephone_number": "407-600-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRUMMEN",
        "first_name": "DIANE",
        "middle_name": "MICHELLE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": "MA64792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "JENKINS",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mithun Mathew
• Jeffrey Mathews
• Karen Kelley Mathis, PAC
• Max Forni DMD P.a.
• Diane McCray-Brown, OTA/L
• Katherine McDonald, LMHC
• David Francis McDowall, D.D.S.
• McKeon Chiropractic Clinic PA
• Mark John McKeon, D.C.
• Thomas Daniel McKeon Jr., D.C.

• Massage Therapist in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.