Individual provider Active NPI

Laurie McKee, LMT

  • Specialist
  • Jacksonville, FL
National Provider Identifier
1629149992
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA-20053 Issued in FL
Practice address
4282 Herschel St
Jacksonville, FL 32210-2247
Phone
(904) 384-3453
Fax
(904) 384-3453
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA-20053 FL Primary

Addresses

Primary practice location

4282 Herschel St
Jacksonville, FL 32210-2247

Mailing address

2605 Independence Dr
Jacksonville Beach, FL 32250-2519
Phone (904) 241-5229

Other identifiers 2

IdentifierTypeStateIssuer
16559OtherFLMM LICENSE NUMBER
20053OtherFLMA LICENSE NUMBER

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

LicenseStateTypeSpecialty
MA-20053FLMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629149992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 INDEPENDENCE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322502519",
            "telephone_number": "904-241-5229",
            "fax_number": "904-384-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4282 HERSCHEL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102247",
            "telephone_number": "904-384-3453",
            "fax_number": "904-384-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "LAURIE",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA-20053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MM LICENSE NUMBER",
            "identifier": "16559",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA LICENSE NUMBER",
            "identifier": "20053",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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.

Verify at the official NPI Registry.