Individual provider Active NPI

Justine R Lucia, LMT

  • Massage Therapist
  • Bend, OR
National Provider Identifier
1922443720
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
17408 Issued in OR
Practice address
222 SE Urania LN
Bend, OR 97702-1624
Phone
(541) 647-0493
NPI assigned
May 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2013

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 17408 OR Primary

Addresses

Primary practice location

222 SE Urania LN
Bend, OR 97702-1624

Mailing address

61183 Fir Crest KNL
Bend, OR 97702-2568
Phone (541) 647-0493

Other identifiers 1

IdentifierTypeStateIssuer
LMT 17408OtherOROREGON LICENSE

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
17408ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1922443720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61183 FIR CREST KNL",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022568",
            "telephone_number": "541-647-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SE URANIA LN",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021624",
            "telephone_number": "541-647-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIA",
        "first_name": "JUSTINE",
        "middle_name": "R",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "17408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON LICENSE",
            "identifier": "LMT 17408",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; 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.