Stephanie Renate Ellis, LMBT7685

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

07685 Issued in NC

Practice address

111 E Fremont St RM 1
Burgaw, NC 28425-5244

Phone

(910) 431-3325

NPI assigned

Sep 29, 2026

Last updated

Sep 29, 2026By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1790640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1043124811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HORSESHOE LN",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284258230",
            "telephone_number": "910-431-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E FREMONT ST RM 1",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284255244",
            "telephone_number": "910-431-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "STEPHANIE",
        "middle_name": "RENATE",
        "credential": "LMBT7685",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "07685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.