Active NPI
Lisa Juanita Wilson, CMT
- Massage Therapist
- Mount Pleasant, MI
National Provider Identifier
1740442912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 304 W Michigan St
Suite# 5
Mount Pleasant, MI 48858-2492 - Phone
- (989) 572-8117
- NPI assigned
- Jun 30, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | Primary | ||
| Naturopath | 175F00000X |
Addresses
Primary practice location
304 W Michigan St
Suite# 5
Mount Pleasant, MI 48858-2492
Mailing address
304 W Michigan St
Suite# 5
Mount Pleasant, MI 48858-2492
Phone (989) 572-8117
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215734400000",
"number": "1740442912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 W MICHIGAN ST",
"address_2": "SUITE# 5",
"city": "MOUNT PLEASANT",
"state": "MI",
"postal_code": "488582492",
"telephone_number": "989-572-8117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 W MICHIGAN ST",
"address_2": "SUITE# 5",
"city": "MOUNT PLEASANT",
"state": "MI",
"postal_code": "488582492",
"telephone_number": "989-572-8117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LISA",
"middle_name": "JUANITA",
"name_prefix": "Mrs.",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-30",
"last_updated": "2008-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.