Active NPI
Nikita Lyashenko, LMT
- Massage Therapist
- Tampa, FL
National Provider Identifier
1548532906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA55642
- Practice address
- 3619 Henderson Blvd
Tampa, FL 33609-4501 - Phone
- (813) 532-7462
- NPI assigned
- Feb 1, 2012
- Last updated
- Feb 1, 2012
- Sex
- Male
- 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 | MA55642 | FL | Primary |
Addresses
Primary practice location
3619 Henderson Blvd
Tampa, FL 33609-4501
Mailing address
3619 Henderson Blvd
Tampa, FL 33609-4501
Phone (813) 532-7462
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA55642 | Other | FL | LMT |
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 |
|---|---|---|---|
| MA55642 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328054400000",
"number": "1548532906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3619 HENDERSON BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336094501",
"telephone_number": "813-532-7462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3619 HENDERSON BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336094501",
"telephone_number": "813-532-7462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYASHENKO",
"first_name": "NIKITA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-01",
"last_updated": "2012-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA55642",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMT",
"identifier": "MA55642",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.