Individual provider Active NPI

Rachel Irene Harrell, LMT,NCBTMB,MMP

  • Massage Therapist
  • Lakeland, FL
National Provider Identifier
1659522654
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA44912 Issued in FL
Practice address
702 S New York Ave
Suite 3
Lakeland, FL 33815-4748
Phone
(813) 506-3245
NPI assigned
Oct 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA44912 FL Primary

Addresses

Primary practice location

702 S New York Ave
Suite 3
Lakeland, FL 33815-4748

Mailing address

330 Doris Dr
Lakeland, FL 33813-1007
Phone (863) 808-9779

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
MA44912FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1659522654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 DORIS DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131007",
            "telephone_number": "863-808-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 S NEW YORK AVE",
            "address_2": "SUITE 3",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338154748",
            "telephone_number": "813-506-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "RACHEL",
        "middle_name": "IRENE",
        "credential": "LMT,NCBTMB,MMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA44912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.