Active NPI
Laura Lee Harris, LMT
- Massage Therapist
- Jacksonville, FL
National Provider Identifier
1487751996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA41894
- Practice address
- 5135 San Juan Ave
Jacksonville, FL 32210 - Phone
- (904) 388-0900
- Fax
- (904) 388-0977
- NPI assigned
- Sep 19, 2006
- 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 | MA41894 | FL | Primary |
Addresses
Primary practice location
5135 San Juan Ave
Jacksonville, FL 32210
Mailing address
2625 Moody Ave
Orange Park, FL 32073
Phone (904) 545-9654
Other names 1
- Miss Laura Lee Whitesides
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 |
|---|---|---|---|
| MA41894 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487751996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 MOODY AVE",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "32073",
"telephone_number": "904-545-9654",
"fax_number": "904-388-0977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5135 SAN JUAN AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32210",
"telephone_number": "904-388-0900",
"fax_number": "904-388-0977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "LAURA",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA41894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAURA",
"last_name": "WHITESIDES",
"middle_name": "LEE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.