Active NPI
Jennifer Lake, LMT
- Massage Therapist
- Hixson, TN
National Provider Identifier
1467799940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT0000009393
- Practice address
- 5211 Highway 153 Ste D
Hixson, TN 37343-4957 - Phone
- (423) 875-9797
- NPI assigned
- Jan 3, 2013
- Sex
- Female
- Sole proprietor
- No
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 | MT0000009393 | TN | Primary |
Addresses
Primary practice location
5211 Highway 153 Ste D
Hixson, TN 37343-4957
Mailing address
5211 Hwy 153 Ste D
Hixson, TN 37343
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 |
|---|---|---|---|
| MT0000009393 | TN | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Slender Wrap of Chattanooga | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Venus Med Spa
- Ambulatory Surgical Clinic/Center
- Hixson, TN
- NPI 1548513286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357171200000",
"number": "1467799940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5211 HWY 153 STE D",
"city": "HIXSON",
"state": "TN",
"postal_code": "37343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5211 HIGHWAY 153 STE D",
"city": "HIXSON",
"state": "TN",
"postal_code": "373434957",
"telephone_number": "423-875-9797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "JENNIFER",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-03",
"last_updated": "2013-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TN",
"license": "MT0000009393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hixson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.