Active NPI
Deborah Lea Wedge, LMT
- Massage Therapist
- Clermont, FL
National Provider Identifier
1669641825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA48076
- Practice address
- 12832 Valley Ridge Rd
Clermont, FL 34711-6717 - Phone
- (352) 255-5328
- NPI assigned
- Feb 21, 2008
- Sex
- Female
- 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 | MA48076 | FL | Primary |
Addresses
Primary practice location
12832 Valley Ridge Rd
Clermont, FL 34711-6717
Mailing address
12832 Valley Ridge Rd
Clermont, FL 34711-6717
Phone (352) 255-5328
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA48076 | Other | FL | STATE LICENSE |
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 |
|---|---|---|---|
| MA48076 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203552000000",
"number": "1669641825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12832 VALLEY RIDGE RD",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347116717",
"telephone_number": "352-255-5328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12832 VALLEY RIDGE RD",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347116717",
"telephone_number": "352-255-5328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEDGE",
"first_name": "DEBORAH",
"middle_name": "LEA",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-21",
"last_updated": "2008-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA48076",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "MA48076",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.