Active NPI
Loresa Robertson, LMT
- Massage Therapist
- Detroit, MI
National Provider Identifier
1306082557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- BUS2005-00300
- Practice address
- 600 Renaissance Ctr # 1
Detroit, MI 48243-1815 - Phone
- (313) 393-7995
- NPI assigned
- Dec 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | BUS2005-00300 | MI | Primary |
Addresses
Primary practice location
600 Renaissance Ctr # 1
Detroit, MI 48243-1815
Mailing address
600 Renaissance Ctr # 1
Detroit, MI 48243-1815
Phone (313) 393-7995
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 |
|---|---|---|---|
| BUS2005-00300 | MI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corporate Mind Body Spa LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Contractor
- Detroit, MI
- NPI 1407087299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229472000000",
"number": "1306082557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 RENAISSANCE CTR # 1",
"city": "DETROIT",
"state": "MI",
"postal_code": "482431815",
"telephone_number": "313-393-7995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 RENAISSANCE CTR # 1",
"city": "DETROIT",
"state": "MI",
"postal_code": "482431815",
"telephone_number": "313-393-7995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "LORESA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-17",
"last_updated": "2008-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MI",
"license": "BUS2005-00300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.