Active NPI
Jessica Rene Lyden
- Massage Therapist
- Corpus Christi, TX
National Provider Identifier
1225715592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 114851
- Practice address
- 4220 S Padre Island Dr Ste a
Corpus Christi, TX 78411-4428 - Phone
- (361) 462-1867
- NPI assigned
- Jun 29, 2023
- Last updated
- Jun 29, 2023
- 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 | 114851 | TX | Primary |
Addresses
Primary practice location
4220 S Padre Island Dr Ste a
Corpus Christi, TX 78411-4428
Mailing address
4220 S Padre Island Dr Ste a
Corpus Christi, TX 78411-4428
Phone (361) 462-1867
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 |
|---|---|---|---|
| 114851 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1225715592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4220 S PADRE ISLAND DR STE A",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784114428",
"telephone_number": "361-462-1867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4220 S PADRE ISLAND DR STE A",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784114428",
"telephone_number": "361-462-1867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYDEN",
"first_name": "JESSICA",
"middle_name": "RENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-29",
"last_updated": "2023-06-29",
"certification_date": "2023-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "114851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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- Antonio J.N. Lykos, DO
- Tammy L Lykos, D.D.S.
- Jerry Douglas Lynch, PA
- Tabitha Lytle, PHARMD
- M Ayman Ghraowi, MD PA (Northwest Cancer Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.