Active NPI
Therese Jeanne Leeds, LMT
- Massage Therapist
- Holly Hill, FL
National Provider Identifier
1396984183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA54222
- Practice address
- 240 Ridgewood Ave
Holly Hill, FL 32117-4944 - Phone
- (386) 492-2958
- NPI assigned
- Feb 18, 2009
- 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 | MA54222 | FL | Primary |
Addresses
Primary practice location
240 Ridgewood Ave
Holly Hill, FL 32117-4944
Mailing address
240 Ridgewood Avenue
Holly Hill, FL 32117-4944
Phone (386) 492-2958
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 |
|---|---|---|---|
| MA54222 | FL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Newagetouch | Massage Therapist | 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.
-
- Massage Therapist
- Holly Hill, FL
- NPI 1982930442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280102400000",
"number": "1396984183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 RIDGEWOOD AVENUE",
"city": "HOLLY HILL",
"state": "FL",
"postal_code": "321174944",
"telephone_number": "386-492-2958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 RIDGEWOOD AVE",
"city": "HOLLY HILL",
"state": "FL",
"postal_code": "321174944",
"telephone_number": "386-492-2958"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEEDS",
"first_name": "THERESE",
"middle_name": "JEANNE",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-18",
"last_updated": "2010-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA54222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holly Hill, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.