Individual provider Active NPI

Kelly Jean Lindsay

  • Massage Therapist
  • Longview, TX
National Provider Identifier
1902208226
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT011363 Issued in TX
Practice address
452 Forest SQ
Longview, TX 75605-4401
Phone
(903) 757-3400
NPI assigned
Sep 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT011363 TX Primary

Addresses

Primary practice location

452 Forest SQ
Longview, TX 75605-4401

Mailing address

452 Forest SQ
Longview, TX 75605-4401
Phone (903) 757-3400

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

LicenseStateTypeSpecialty
MT011363TXMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Performance Chiropractic, P.a. PastSince Oct 16, 2006 Accepting new patients
John E Petty DC PC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1902208226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 FOREST SQ",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054401",
            "telephone_number": "903-757-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 FOREST SQ",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756054401",
            "telephone_number": "903-757-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSAY",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT011363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.