Individual provider Active NPI

Vedshrami Lnu

  • Massage Therapist
  • Lilburn, GA
National Provider Identifier
1104650647
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT011984 Issued in GA
Practice address
331 Rockbridge Rd NW Ste 800
Lilburn, GA 30047-6105
Phone
(706) 572-5916
NPI assigned
Aug 28, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X
Massage Therapist 225700000X MT011984 GA Primary

Addresses

Primary practice location

331 Rockbridge Rd NW Ste 800
Lilburn, GA 30047-6105

Mailing address

1197 Charlie LN SW
Lilburn, GA 30047-4203
Phone (706) 572-5916

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
MT011984GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1104650647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1197 CHARLIE LN SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300474203",
            "telephone_number": "706-572-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 ROCKBRIDGE RD NW STE 800",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300476105",
            "telephone_number": "706-572-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LNU",
        "first_name": "VEDSHRAMI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-28",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT011984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.