Individual provider Active NPI

Ian Collier Lemasters, LMT

  • Massage Therapist
  • Portland, OR
National Provider Identifier
1417538158
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
26256 Issued in OR
Practice address
4927 NE 30TH Ave
Portland, OR 97211-7007
Phone
(503) 281-0681
NPI assigned
Apr 15, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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 26256 OR Primary

Addresses

Primary practice location

4927 NE 30TH Ave
Portland, OR 97211-7007

Mailing address

5262 NE 29TH Ave
Portland, OR 97211-6240
Phone (409) 656-6465

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
26256ORMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Oldendorf Massage Therapist PastSince Apr 20, 2021 Accepting new patients
Michelle Reynolds PastSince Apr 20, 2021 Accepting new patients

Organizations & group practices 2

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": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1417538158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5262 NE 29TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972116240",
            "telephone_number": "409-656-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4927 NE 30TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972117007",
            "telephone_number": "503-281-0681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMASTERS",
        "first_name": "IAN",
        "middle_name": "COLLIER",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "26256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.