Kozue Cunningham

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

011949 Issued in GA

Practice address

299 Cooper Rd Ste B
Loganville, GA 30052-2579

Phone

(770) 217-4336

Fax

(770) 686-3429

NPI assigned

Apr 15, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Aos Healing Center, LLC

  • Health Service Clinic/Center
  • Loganville, GA
  • NPI 1467102988

  Massage Therapist

  NPD

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1104670496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 COOPER RD STE B",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522579",
            "telephone_number": "770-217-4336",
            "fax_number": "770-686-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 COOPER RD STE B",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522579",
            "telephone_number": "770-217-4336",
            "fax_number": "770-686-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "KOZUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "011949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Georgia Cumberbatch
• Berooz Daryooni
• Johanne Dastine-Coriolan, NP
• Kyleigh Grace Daugherty, M. ED. CCC-SLP
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• Celeste Davis, CPNP

• Massage Therapist in Loganville, GA
• Providers in Loganville, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.