Active NPI
Odena Lillian Wright
- Massage Therapist
- Fayetteville, GA
National Provider Identifier
1093029936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT000794
- Practice address
- 376 North Glynn St.
Fayetteville, GA 30214 - Phone
- (404) 312-0486
- Fax
- (404) 261-7555
- NPI assigned
- Aug 3, 2010
- Sex
- Female
- Sole proprietor
- No
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 | MT000794 | GA | Primary |
Addresses
Primary practice location
376 North Glynn St.
Fayetteville, GA 30214
Mailing address
P.O. Box 191782
Atlanta, GA 30319
Phone (404) 312-0486
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 |
|---|---|---|---|
| MT000794 | GA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1093029936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 191782",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30319",
"telephone_number": "404-312-0486",
"fax_number": "404-261-7555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "376 NORTH GLYNN ST.",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "30214",
"telephone_number": "404-312-0486",
"fax_number": "404-261-7555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRIGHT",
"first_name": "ODENA",
"middle_name": "LILLIAN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-03",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "GA",
"license": "MT000794",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.