Individual provider Active NPI

Leonnie Brathwaite, LMBT, CT

  • Massage Therapist
  • Raleigh, NC
National Provider Identifier
1255043154
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
14883 Issued in NC
Practice address
10931 Raven Ridge Rd Ste 103
Raleigh, NC 27614-6499
Phone
(919) 865-6900
NPI assigned
Dec 22, 2022
Last updated
Dec 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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 14883 NC Primary

Addresses

Primary practice location

10931 Raven Ridge Rd Ste 103
Raleigh, NC 27614-6499

Mailing address

4205 Cobia CT Apt a
Raleigh, NC 27604-7217
Phone (704) 606-9339

Other identifiers 1

IdentifierTypeStateIssuer
14883OtherNCLMBT #

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
14883NCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Works, PLLC CurrentSince Dec 28, 2022 Accepting new patients

Locations

10931 Raven Ridge Rd
Ste 103
Raleigh, NC 27614
Phone (919) 256-0900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1255043154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 COBIA CT APT A",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276047217",
            "telephone_number": "704-606-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10931 RAVEN RIDGE RD STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146499",
            "telephone_number": "919-865-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATHWAITE",
        "first_name": "LEONNIE",
        "name_prefix": "Ms.",
        "credential": "LMBT, CT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "14883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMBT #",
            "identifier": "14883",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.