Chandra Dawn Justice, MMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

157062 Issued in OK

Practice address

101 N Kemp Ave
Tishomingo, OK 73460-1719

Phone

(580) 371-7362

NPI assigned

Jul 31, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Chandra Dawn Hall Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1003394263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 N BYRD ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734601411",
            "telephone_number": "580-371-7362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N KEMP AVE",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734601719",
            "telephone_number": "580-371-7362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "CHANDRA",
        "middle_name": "DAWN",
        "credential": "MMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OK",
            "license": "157062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANDRA",
            "last_name": "HALL",
            "middle_name": "DAWN",
            "credential": "MMP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Johnston County Emergency Medical Services
• Johnston County Hospital LLC
• Sheila D Jones
• Stephanie Patricia Jones, DO
• Janet Renee' Julian, DDS
• Danielle Ophellia Kemp, BS, BHRS
• Georgia Kemp
• Cade Joseph Kennison
• Alisha Khan, CF-SLP
• Carol Sue Kimbro, LPC

• Massage Therapist in Tishomingo, OK
• Providers in Tishomingo, OK by specialty
• Massage Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.