Active NPI
Amy Diane Lagrange, LMT
- Massage Therapist
- Albuquerque, NM
National Provider Identifier
1265700934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 4833
- Practice address
- 4700 Jefferson St NE
Suite 100
Albuquerque, NM 87109-2136 - Phone
- (505) 925-7464
- Fax
- (505) 925-4539
- NPI assigned
- Dec 8, 2011
- 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 | 4833 | NM | Primary |
Addresses
Primary practice location
4700 Jefferson St NE
Suite 100
Albuquerque, NM 87109-2136
Mailing address
933 Bradbury SE
Suite 2222
Albuquerque, NM 87106-4301
Phone (505) 272-2521
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 |
|---|---|---|---|
| 4833 | NM | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323302400000",
"number": "1265700934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 BRADBURY SE",
"address_2": "SUITE 2222",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064301",
"telephone_number": "505-272-2521",
"fax_number": "505-272-3238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 JEFFERSON ST NE",
"address_2": "SUITE 100",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871092136",
"telephone_number": "505-925-7464",
"fax_number": "505-925-4539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAGRANGE",
"first_name": "AMY",
"middle_name": "DIANE",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-08",
"last_updated": "2011-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "4833",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.