Active NPI
Bonnie White, MASSGE THEARAPIST
- Massage Therapist
- Dalton, GA
National Provider Identifier
1043539620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT005007
- Practice address
- 801 N Tibbs Rd
Dalton, GA 30720-2948 - Phone
- (706) 279-1336
- NPI assigned
- May 22, 2010
- Last updated
- May 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | MT005007 | GA | Primary |
Addresses
Primary practice location
801 N Tibbs Rd
Dalton, GA 30720-2948
Mailing address
PO Box 2681
Dalton, GA 30722-2681
Phone (706) 279-1336
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 |
|---|---|---|---|
| MT005007 | GA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274486400000",
"number": "1043539620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2681",
"city": "DALTON",
"state": "GA",
"postal_code": "307222681",
"telephone_number": "706-279-1336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 N TIBBS RD",
"city": "DALTON",
"state": "GA",
"postal_code": "307202948",
"telephone_number": "706-279-1336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "BONNIE",
"name_prefix": "Mrs.",
"credential": "MASSGE THEARAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-22",
"last_updated": "2010-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "GA",
"license": "MT005007",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dalton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.