NPIMap

Organization Active NPI

Emerald Lane Therapy Inc.

  • Occupational Medicine Physician
  • Lawton, OK
National Provider Identifier
1366815334
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
MT306698 Issued in TX
Legal business name
EMERALD LANE THERAPY INC.
Practice address
1016 SW C Ave Ste a
Lawton, OK 73501-4451
Phone
(580) 699-8777
Fax
(580) 699-2747
NPI assigned
Nov 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amber Lynn Delger, LMT
Title
Ceo
Phone
(580) 699-8777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083X0100X MT306698 TX Primary

Addresses

Primary practice location

1016 SW C Ave Ste a
Lawton, OK 73501-4451

Mailing address

1016 SW C Ave Ste a
Lawton, OK 73501-4451
Phone (580) 699-7777

Other names 1

  • Emerald Lane Massage Studio Former legal business name

National Provider Directory

National Provider Directory

Locations

1016 SW C Ave
Ste A
Lawton, OK 73501
Phone (580) 699-8777

NPI Registry JSON

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

{
    "created_epoch": "1447286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1366815334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 SW C AVE STE A",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735014451",
            "telephone_number": "580-699-7777",
            "fax_number": "580-699-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 SW C AVE STE A",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735014451",
            "telephone_number": "580-699-8777",
            "fax_number": "580-699-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD LANE THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-12",
        "last_updated": "2022-11-17",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "DELGER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "580-699-8777",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "TX",
            "license": "MT306698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Lane Massage Studio",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.