Active NPI
Lisa Christine Kazmar, LPTA, LMTA
- Massage Therapist
- Edgewood, NM
National Provider Identifier
1891967543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT9403
- Practice address
- 1917 Old Hwy 66
Edgewood, NM 87015 - Phone
- (505) 917-3631
- NPI assigned
- Apr 1, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A-0575 | NM | |
| Massage Therapist | 225700000X | MT9403 | NM | Primary |
Addresses
Primary practice location
1917 Old Hwy 66
Edgewood, NM 87015
Mailing address
PO Box 2227
Edgewood, NM 87015-2227
Phone (505) 917-3631
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 |
|---|---|---|---|
| A-0575 | NM | MD | Physical Therapy Assistant |
| MT9403 | NM | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701302400000",
"number": "1891967543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2227",
"city": "EDGEWOOD",
"state": "NM",
"postal_code": "870152227",
"telephone_number": "505-917-3631",
"fax_number": "505-281-4997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1917 OLD HWY 66",
"city": "EDGEWOOD",
"state": "NM",
"postal_code": "87015",
"telephone_number": "505-917-3631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAZMAR",
"first_name": "LISA",
"middle_name": "CHRISTINE",
"name_prefix": "Mrs.",
"credential": "LPTA, LMTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-01",
"last_updated": "2023-11-30",
"certification_date": "2023-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NM",
"license": "A-0575",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "MT9403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edgewood, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.