Active NPI
Deonna Monique Nicole Harris, LMBT
- Massage Therapist
- Fayetteville, NC
National Provider Identifier
1023861580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 20884
- Practice address
- 4810 Arbor Rd
Fayetteville, NC 28311-1661 - Phone
- (757) 218-8629
- NPI assigned
- Apr 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 0019018669 | VA | |
| Massage Therapist | 225700000X | 20884 | NC | Primary |
Addresses
Primary practice location
4810 Arbor Rd
Fayetteville, NC 28311-1661
Mailing address
4810 Arbor Rd
Fayetteville, NC 28311-1661
Phone (757) 218-8629
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 |
|---|---|---|---|
| 20884 | NC | MD | Pediatrics Physician |
| 0019018669 | VA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712275200000",
"number": "1023861580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4810 ARBOR RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283111661",
"telephone_number": "757-218-8629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4810 ARBOR RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283111661",
"telephone_number": "757-218-8629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "DEONNA",
"middle_name": "MONIQUE NICOLE",
"credential": "LMBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-05",
"last_updated": "2024-04-05",
"certification_date": "2024-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "VA",
"license": "0019018669",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "20884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.