Individual provider Active NPI

Bernadette Lee Lafferty, LMT

  • Massage Therapist
  • Prescott, AZ
National Provider Identifier
1174838692
Registry record updated Oct 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT-13777 Issued in AZ
Practice address
634 Schemmer Dr
Suite 202
Prescott, AZ 86305-2362
Phone
(928) 925-3051
NPI assigned
Aug 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT-13777 AZ Primary

Addresses

Primary practice location

634 Schemmer Dr
Suite 202
Prescott, AZ 86305-2362

Mailing address

1930 S. Road 1 West
Chino Valley, AZ 86323
Phone (928) 925-3051

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
MT-13777AZMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286064000000",
    "number": "1174838692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 S. ROAD 1 WEST",
            "city": "CHINO VALLEY",
            "state": "AZ",
            "postal_code": "86323",
            "telephone_number": "928-925-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 SCHEMMER DR",
            "address_2": "SUITE 202",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863052362",
            "telephone_number": "928-925-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFFERTY",
        "first_name": "BERNADETTE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AZ",
            "license": "MT-13777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

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

Verify at the official NPI Registry.