Individual provider Active NPI

Torya Lache' Harris, LMT

  • Massage Therapist
  • Warner Robins, GA
National Provider Identifier
1912359670
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT004335 Issued in GA
Practice address
2050 Watson Blvd Ste a
Warner Robins, GA 31093-3625
Phone
(478) 352-1264
NPI assigned
Jul 6, 2016
Last updated
May 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA001309 GA
Massage Therapist 225700000X MT004335 GA Primary

Addresses

Primary practice location

2050 Watson Blvd Ste a
Warner Robins, GA 31093-3625

Mailing address

4501 Russell Pkwy Ste 37
Warner Robins, GA 31088-8681
Phone (478) 352-1264

Other practice location 1

114 Amelia Dr
Byron, GA 31008-3503
Phone (478) 284-8151

Other practice location 2

4501 Russell Pkwy Ste 37
Warner Robins, GA 31088-8681
Phone (478) 352-1264

Other identifiers 1

IdentifierTypeStateIssuer
81-3152487MedicaidGA

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
OTA001309GAMDOccupational Therapy Assistant
MT004335GAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Manual Therapy Clinic Massage Therapist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1912359670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 RUSSELL PKWY STE 37",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888681",
            "telephone_number": "478-352-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 WATSON BLVD STE A",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933625",
            "telephone_number": "478-352-1264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Amelia Dr",
            "address_purpose": "LOCATION",
            "city": "Byron",
            "state": "GA",
            "postal_code": "310083503",
            "country_code": "US",
            "telephone_number": "478-284-8151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4501 Russell Pkwy Ste 37",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310888681",
            "country_code": "US",
            "telephone_number": "478-352-1264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TORYA",
        "middle_name": "LACHE'",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "OTA001309",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT004335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81-3152487",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.