Individual provider Active NPI

Darica J Reid

  • Massage Therapist
  • Loganville, GA
National Provider Identifier
1053105064
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT012298 Issued in GA
Practice address
299 Cooper Rd Ste B
Loganville, GA 30052-2579
Phone
(770) 217-4336
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT012298 GA Primary

Addresses

Primary practice location

299 Cooper Rd Ste B
Loganville, GA 30052-2579

Mailing address

2948 Sanibel Dr
Stone Mountain, GA 30087-4225
Phone (937) 321-7174

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

LicenseStateTypeSpecialty
MT012298GAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aos Healing Center, LLC Massage Therapist CurrentSince Apr 13, 2025 Accepting new patients

Locations

299 Cooper Rd
Ste B
Loganville, GA 30052
Phone (706) 250-1769

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1053105064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2948 SANIBEL DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874225",
            "telephone_number": "937-321-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 COOPER RD STE B",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522579",
            "telephone_number": "770-217-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "DARICA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT012298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.