Skin Revive Massage and Spa, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

SKIN REVIVE MASSAGE AND SPA, LLC

Practice address

13453 N Main St Ste 304
Jacksonville, FL 32218-2273

Phone

(904) 955-2706

NPI assigned

Feb 27, 2023

Last updated

Feb 27, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tara Lester, LMTNPI 1215636360

Title

Licensed Massage Therapist/Owner

Phone

(904) 955-2706

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tara Lester, LMT,

  • Massage Therapist
  • Jacksonville, FL
  • NPI 1215636360
  NPD Authorized official
• Chunxia Wang

  • Massage Therapist
  • Jacksonville, FL
  • NPI 1861245052
  NPD
• Kendra Garcia

  • Massage Therapist
  • Jacksonville, FL
  • NPI 1720938590

  Single Specialty

  NPD (past)
• Zianni Jones

  • Massage Therapist
  • Jacksonville, FL
  • NPI 1861324766
  NPD (past)

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1427757723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182273",
            "telephone_number": "904-955-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST STE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182273",
            "telephone_number": "904-955-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN REVIVE MASSAGE AND SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-26",
        "status": "A",
        "authorized_official_last_name": "LESTER",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "LICENSED MASSAGE THERAPIST/OWNER",
        "authorized_official_telephone_number": "904-955-2706",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Freida Ruth Skinner, OTD., OTR/L
• Raheem M Skinner, PT
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• Hannah Lynn Skipper, PHARMD

• Massage Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.