Individual provider Active NPI

Annette Lilja Parker, LMT

  • Massage Therapist
  • Terra Alta, WV
National Provider Identifier
1376046458
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
2018-3595 Issued in WV
Practice address
114 Alpine Lake Rd
Terra Alta, WV 26764-7700
Phone
(304) 777-0958
NPI assigned
Mar 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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 2018-3595 WV Primary

Addresses

Primary practice location

114 Alpine Lake Rd
Terra Alta, WV 26764-7700

Mailing address

279 Casteel Rd
Terra Alta, WV 26764-6175
Phone (304) 777-7133

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
2018-3595WVMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1376046458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 CASTEEL RD",
            "city": "TERRA ALTA",
            "state": "WV",
            "postal_code": "267646175",
            "telephone_number": "304-777-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ALPINE LAKE RD",
            "city": "TERRA ALTA",
            "state": "WV",
            "postal_code": "267647700",
            "telephone_number": "304-777-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "ANNETTE",
        "middle_name": "LILJA",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WV",
            "license": "2018-3595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terra Alta, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; 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.