Lori A Wikle, L.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

158594 Issued in AK

Practice address

308 Old Steese Hwy
Fairbanks, AK 99701-3126

Phone

(907) 451-7246

NPI assigned

Aug 18, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jace LLC

  • Massage Therapist
  • Fairbanks, AK
  • NPI 1740024249
  NPD Authorized official

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1801408307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC01 BOX 2642",
            "address_2": "MILE 156 GLENN HWY",
            "city": "GLENNALLEN",
            "state": "AK",
            "postal_code": "99588",
            "telephone_number": "605-941-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 OLD STEESE HWY",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013126",
            "telephone_number": "907-451-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Mile 156 Glenn Hwy",
            "address_purpose": "LOCATION",
            "city": "Glennallen",
            "state": "AK",
            "postal_code": "99588",
            "country_code": "US",
            "telephone_number": "605-941-4055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3330 Plack Road",
            "address_purpose": "LOCATION",
            "city": "North Pole",
            "state": "AK",
            "postal_code": "99705",
            "country_code": "US",
            "telephone_number": "605-941-4055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIKLE",
        "first_name": "LORI",
        "middle_name": "A",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "158594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Walter Wietgrefe
• Magan Kathryn Wiggs, SLP-A
• Stephanie Wight, PT, DPT
• Mason Wigley
• Emily Haze Wikle Burgess, LMT
• Aisha Correa Wilbur, D.P.T.
• Rebecca Wilbur
• Prycilla Wilburn
• Christina Wilcher
• Michael Wilcher

• Massage Therapist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.