Amanda Gail Stephenson, L.M.T

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

20102705 Issued in WV

Practice address

463D Old Bluefield Rd
Princeton, WV 24740-8927

Phone

(304) 952-2942

NPI assigned

Jul 1, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Amanda G Stephenson

  • Massage Therapist
  • Princeton, WV
  • NPI 1073825683
  NPD (past) Authorized official

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1124339486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463D OLD BLUEFIELD RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247408927",
            "telephone_number": "304-952-2942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463D OLD BLUEFIELD RD",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247408927",
            "telephone_number": "304-952-2942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "AMANDA",
        "middle_name": "GAIL",
        "name_prefix": "Ms.",
        "credential": "L.M.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-01",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WV",
            "license": "20102705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "2010-2705",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Steven Stefancic, M.D.
• Roger Stefancic
• Hannah C Steffey, FNP
• Booker Stephens II, BA
• Shannon Stephens, MS CCC SLP
• Stepp Family Practice
• Joni Marie Stepp, D.O.
• Samantha Stepp, PNP
• Caleb Levi Stevens, LGSW
• Ayla Stevenson

• All providers in Princeton, WV
• Massage Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.