LISA WIDDOWSON (NPI# 1114490604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114490604 |
| Entity Type | Individual |
| Full Name | LISA WIDDOWSON |
| Credential | LMT, CTT |
| Practice Address |
7200 S 84th St Ste 140 La Vista NE 68128-2115 |
| Mailing Address |
7210 S 75th St La Vista NE 68128-2220 |
| Practice Telephone | 4029151590 |
| Practice Fax Number | 4029390614 |
| Mailing Telephone | 4025909384 |
| Mailing Fax Number | 4029390614 |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2019-01-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 2595 | NE | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 347C00000X | Private Vehicle | G01-370662 | NE | Transportation Services |
| N | 173C00000X | Reflexologist | Other Service Providers | ||
| N | 174H00000X | Health Educator | Other Service Providers |
| Street Address |
7200 S 84TH ST STE 140 |
| City | LA VISTA |
| State | NE |
| Zip Code | 68128-2115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922589746 | Ruth Ann Moses | Prevention Professional | 7030 S 110th St, Omaha, NE 68128 | 2018-08-29 |
| 1972945897 | Jenna Leigh Graeve | Physical Therapist | 7040 S 114th St Plz Apt 203, La Vista, NE 68128 | 2013-07-19 |
| 1245564012 | Optum Infusion Services 302, LLC | Pharmacy | 8720 South 114th Street, Suite 106, La Vista, NE 68128 | 2009-09-28 |
| 1730385709 | Granville Assisted Living, LLC | Point of Service | 5807 Granville Parkway, La Vista, NE 68128 | 2007-06-26 |
| 1629160072 | Rachel L. Mccann | Pediatrics | 9801 Giles Road, Suite 1, La Vista, NE 68128 | 2006-09-29 |
| 1730118233 | Donald R Krysl | Optometrist | 8102 S 84th St, Lavista, NE 68128 | 2006-06-30 |
| 1073030607 | September Leigh Wanzenried | Family Medicine | 6901 S 84th St, La Vista, NE 68128 | 2017-08-24 |
| 1518312719 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 12515 Portside Pkwy, La Vista, NE 68128 | 2016-04-26 |
| 1245685445 | Costco Wholesale Corporation | Hearing Aid Equipment | 12515 Portside Pkwy, La Vista, NE 68128 | 2016-04-26 |
| 1386011971 | Kelsey Klatt | Occupational Therapist | 6960 S 110th St, La Vista, NE 68128 | 2015-08-31 |
| Find all providers in zip 68128 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487169116 | Kendra Amidon | Massage Therapist | 12040 Mcdermott Plz Ste 320, La Vista, NE 68128-2354 | 2017-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043829120 | Mary Ann Mcmichael | Massage Therapist | 12305 Gold St Ste 9, Omaha, NE 68144-2760 | 2020-07-24 |
| 1366060592 | Amanda Kay Rawson | Massage Therapist | 407 E Bright St, Oxford, NE 68967-7802 | 2020-07-14 |
| 1245854942 | Teri Lynn Hein | Massage Therapist | 11316 Davenport St, Omaha, NE 68154-2630 | 2020-05-29 |
| 1891318150 | Pure Massage, LLC | Massage Therapist | Pure Massage, LLC, 11316 Davenport St, Omaha, NE 68154 | 2020-05-21 |
| 1851935340 | Anne Danhauer | Massage Therapist | 935 S Locust St, Grand Island, NE 68801-6751 | 2019-10-29 |
| 1710528849 | Jimi Clyde Hughes | Massage Therapist | 11932 Arbor St Ste 100, Omaha, NE 68144-2986 | 2019-09-30 |
| 1053962605 | Brenda Griffith | Massage Therapist | Eagle Pass Court 18, Keystone, NE 69144 | 2019-09-25 |
| 1104483841 | Wendy Rae Bagneschi | Massage Therapist | 151 Bordeaux St # 25, Chadron, NE 69337-2169 | 2019-05-28 |
| 1609330133 | Cynthia M Dickmeyer | Massage Therapist | 3601 Calvert St Ste 25, Lincoln, NE 68506-5797 | 2019-01-29 |
| 1851864599 | Heather Lynne Easton | Massage Therapist | 3601 Calvert St Ste 15, Lincoln, NE 68506-5797 | 2019-01-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.