Lydia Anninos, LMT

Key facts

NPI

1942924428

Entity type

Individual (NPI type 1)

Primary specialty

Massage Therapist 225700000X

License

MT136604 (TX)

Practice address

12702 Toepperwein Rd Ste 142
Live Oak, TX 78233-3266

Phone

(210) 646-9060

NPI assigned

Sep 28, 2022

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Woywood Chiropractic Wellness, PA Multi-Specialty Clinic/Center · Live Oak, TX · NPI 1215187323
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 28, 2022.

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1942924428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12702 TOEPPERWEIN RD STE 142",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12702 TOEPPERWEIN RD STE 142",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333266",
            "telephone_number": "210-646-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNINOS",
        "first_name": "LYDIA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT136604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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