Active NPI
Katlin Mello
- Massage Therapist
- Irmo, SC
National Provider Identifier
1063208510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 13019
- Practice address
- 1720 Dutch Fork Rd
Irmo, SC 29063-8871 - Phone
- (803) 816-2716
- NPI assigned
- Apr 18, 2025
- 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 | 13019 | SC | Primary |
Addresses
Primary practice location
1720 Dutch Fork Rd
Irmo, SC 29063-8871
Mailing address
416 Foxport Dr
Chapin, SC 29036-7544
Phone (272) 209-2678
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 |
|---|---|---|---|
| 13019 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Well LLC | Massage Therapist | Past | Accepting new patients |
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.
-
- Massage Therapist
- Irmo, SC
- NPI 1295214088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744934400000",
"number": "1063208510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 FOXPORT DR",
"city": "CHAPIN",
"state": "SC",
"postal_code": "290367544",
"telephone_number": "272-209-2678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 DUTCH FORK RD",
"city": "IRMO",
"state": "SC",
"postal_code": "290638871",
"telephone_number": "803-816-2716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLO",
"first_name": "KATLIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-18",
"last_updated": "2025-04-18",
"certification_date": "2025-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "SC",
"license": "13019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irmo, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.