Emmanuelle Koni Lewis-Jolley

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA94834 Issued in FL

Practice address

6860 66TH St N
Pinellas Park, FL 33781-5036

Phone

(727) 373-6732

NPI assigned

Apr 22, 2022

Last updated

Apr 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sound Mind and Body Wellness

  • Massage Therapist
  • Pinellas Park, FL
  • NPI 1477296382

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1650585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1598409815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6860 66TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337815036",
            "telephone_number": "727-373-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6860 66TH ST N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337815036",
            "telephone_number": "727-373-6732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS-JOLLEY",
        "first_name": "EMMANUELLE",
        "middle_name": "KONI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-22",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA94834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Vagaro",
            "affiliation": "N",
            "endpointDescription": "Backhouse system",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6860 66th St N",
            "city": "Pinellas Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337815036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Melanie Lemus
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• Lester H McLachlan DO PA
• Leveljump DME LLC
• Life Care Diagnostics
• Life in Motion Physical & Hand Therapy
• Avielle Liles
• Jeng Y Lin, MD
• Lincare Pharmacy Services Inc. (Reliant Pharmacy Services)

• Massage Therapist in Pinellas Park, FL
• Providers in Pinellas Park, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.