Active NPI
Lisa Zucker
- Massage Therapist
- Boulder, CO
National Provider Identifier
1386969624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 6417
- Practice address
- 4730 Walnut St Ste 108
Boulder, CO 80301-2558 - Phone
- (303) 258-3185
- NPI assigned
- Mar 30, 2010
- 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 | 6417 | CO | Primary |
Addresses
Primary practice location
4730 Walnut St Ste 108
Boulder, CO 80301-2558
Mailing address
PO Box 71
Nederland, CO 80466-0071
Phone (303) 258-3185
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 |
|---|---|---|---|
| 6417 | CO | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269907200000",
"number": "1386969624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 71",
"city": "NEDERLAND",
"state": "CO",
"postal_code": "804660071",
"telephone_number": "303-258-3185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4730 WALNUT ST STE 108",
"city": "BOULDER",
"state": "CO",
"postal_code": "803012558",
"telephone_number": "303-258-3185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZUCKER",
"first_name": "LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-30",
"last_updated": "2010-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "6417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.