Active NPI
Lan Wang
- Massage Therapist
- Broken Arrow, OK
National Provider Identifier
1790695153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 182761
- Practice address
- 6505 S Elm PL
Broken Arrow, OK 74011-6629 - Phone
- (918) 907-8881
- NPI assigned
- Sep 9, 2026
- 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 | 182761 | OK | Primary |
Addresses
Primary practice location
6505 S Elm PL
Broken Arrow, OK 74011-6629
Mailing address
11742 S Redbud St
Jenks, OK 74037-4319
Phone (918) 350-6809
Other names 1
- Massage Miracle LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789257600000",
"number": "1790695153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11742 S REDBUD ST",
"city": "JENKS",
"state": "OK",
"postal_code": "740374319",
"telephone_number": "918-350-6809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6505 S ELM PL",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740116629",
"telephone_number": "918-907-8881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "LAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-09-09",
"last_updated": "2026-09-13",
"certification_date": "2026-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OK",
"license": "182761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MASSAGE",
"last_name": "LLC",
"middle_name": "MIRACLE",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.