Active NPI
Ardell Buckey Knight
- Massage Therapist
- Brunswick, GA
National Provider Identifier
1013230341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 00363
- Practice address
- 1111 Glynco Pkwy Ste 300
Brunswick, GA 31525-7933 - Phone
- (912) 262-6552
- Fax
- (912) 262-6599
- NPI assigned
- Mar 1, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 00363 | GA | Primary |
Addresses
Primary practice location
1111 Glynco Pkwy Ste 300
Brunswick, GA 31525-7933
Mailing address
1111 Glynco Pkwy Ste 300
Brunswick, GA 31525-7933
Phone (912) 262-6552
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00363 | GA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267401600000",
"number": "1013230341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 GLYNCO PKWY STE 300",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315257933",
"telephone_number": "912-262-6552",
"fax_number": "912-262-6599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 GLYNCO PKWY STE 300",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315257933",
"telephone_number": "912-262-6552",
"fax_number": "912-262-6599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNIGHT",
"first_name": "ARDELL",
"middle_name": "BUCKEY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-01",
"last_updated": "2010-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "GA",
"license": "00363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.