Active NPI
O'Lesa Dennette Allen
- Massage Therapist
- Southfield, MI
National Provider Identifier
1396207668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 7501006879
- Practice address
- 25750 Lahser Rd
Southfield, MI 48033-5809 - Phone
- (248) 415-2500
- NPI assigned
- Apr 4, 2019
- 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 | 7501006879 | MI | Primary |
Addresses
Primary practice location
25750 Lahser Rd
Southfield, MI 48033-5809
Mailing address
25750 Lahser Rd
Southfield, MI 48033-5809
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 |
|---|---|---|---|
| 7501006879 | MI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Irvine Neuro Rehabilitation | Single Specialty | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1396207668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25750 LAHSER RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480335809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25750 LAHSER RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480335809",
"telephone_number": "248-415-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "O'LESA",
"middle_name": "DENNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-04",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "MI",
"license": "7501006879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.