Active NPI
Revenda Ja-Mell Morgan, LMBT
- Massage Therapist
- Winston Salem, NC
National Provider Identifier
1073284121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 08881
- Practice address
- 1350 Pleasant St
Winston Salem, NC 27107-1433 - Phone
- (336) 251-4848
- NPI assigned
- Sep 27, 2021
- 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 | 08881 | NC | Primary |
Addresses
Primary practice location
1350 Pleasant St
Winston Salem, NC 27107-1433
Mailing address
1350 Pleasant St
Winston Salem, NC 27107-1433
Phone (336) 251-4848
Other names 1
- Revenda Ja-Mell Morgan
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 |
|---|---|---|---|
| 08881 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632700800000",
"number": "1073284121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 PLEASANT ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271071433",
"telephone_number": "336-251-4848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 PLEASANT ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271071433",
"telephone_number": "336-251-4848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORGAN",
"first_name": "REVENDA",
"middle_name": "JA-MELL",
"credential": "LMBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-27",
"last_updated": "2021-09-27",
"certification_date": "2021-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "08881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "REVENDA",
"last_name": "MORGAN",
"middle_name": "JA-MELL",
"credential": "NCBTMB CE PROVIDER",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.