Daniell Nicole Lucas

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT039868 Issued in TX

Practice address

114 Lake Forest CT
Garland, TX 75044-4221

Phone

(214) 587-8655

NPI assigned

Apr 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Elite 360 Health and Wellness

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Dallas, TX
  • NPI 1376016410
  NPD Authorized official

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1861055600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8911 DARTWAY DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752277216",
            "telephone_number": "214-587-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 LAKE FOREST CT",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750444221",
            "telephone_number": "214-587-8655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1409 S Lamar St.",
            "address_2": "Ste. 245",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752156818",
            "country_code": "US",
            "telephone_number": "214-587-8655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8911 Dartway Dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752277216",
            "country_code": "US",
            "telephone_number": "214-587-8655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "DANIELL",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2023-01-05",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT039868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Garland, TX
• Providers in Garland, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.