Individual provider Active NPI

Latia Flewellyn, LMT

  • Massage Therapist
  • Detroit, MI
National Provider Identifier
1366052433
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501008822 Issued in MI
Practice address
8325 E Jefferson Ave
Detroit, MI 48214-2797
Phone
(313) 566-4866
NPI assigned
Aug 4, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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 7501008822 MI Primary

Addresses

Primary practice location

8325 E Jefferson Ave
Detroit, MI 48214-2797

Mailing address

4875 Chalmers St
Detroit, MI 48215-2162
Phone (313) 566-4866

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
7501008822MIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Touch, LLC Massage Therapist CurrentSince Aug 9, 2020 Accepting new patients

Locations

8325 E Jefferson Ave
Detroit, MI 48214
Phone (313) 566-4866

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.

NPI Registry JSON

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1366052433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4875 CHALMERS ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152162",
            "telephone_number": "313-566-4866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8325 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482142797",
            "telephone_number": "313-566-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEWELLYN",
        "first_name": "LATIA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501008822",
            "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 Aug 4, 2020; 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.