Active NPI
Saundra K Avery, LPN, LMT
- Massage Therapist
- Canton, MI
National Provider Identifier
1083171151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 7501000228
- Practice address
- 8399 Holly Dr
Canton, MI 48187-4237 - Phone
- (734) 218-0505
- NPI assigned
- Feb 26, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 4703113427 | MI | |
| Massage Therapist | 225700000X | 7501000228 | MI | Primary |
Addresses
Primary practice location
8399 Holly Dr
Canton, MI 48187-4237
Mailing address
8399 Holly Dr
Canton, MI 48187-4237
Phone (734) 218-0505
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 |
|---|---|---|---|
| 4703113427 | MI | MD | Licensed Practical Nurse |
| 7501000228 | MI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551139200000",
"number": "1083171151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8399 HOLLY DR",
"city": "CANTON",
"state": "MI",
"postal_code": "481874237",
"telephone_number": "734-218-0505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8399 HOLLY DR",
"city": "CANTON",
"state": "MI",
"postal_code": "481874237",
"telephone_number": "734-218-0505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVERY",
"first_name": "SAUNDRA",
"middle_name": "K",
"credential": "LPN, LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-26",
"last_updated": "2019-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "4703113427",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MI",
"license": "7501000228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.