Active NPI
Brenda Ann Eley, LMT
- Massage Therapist
- Myrtle Beach, SC
National Provider Identifier
1124368733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 8012
- Practice address
- 4736 Highway 17 Byp S
Myrtle Beach, SC 29588-5616 - Phone
- (843) 444-9355
- Fax
- (843) 294-0019
- NPI assigned
- Feb 19, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 8012 | SC | Primary |
Addresses
Primary practice location
4736 Highway 17 Byp S
Myrtle Beach, SC 29588-5616
Mailing address
630 River Bend Rd
Myrtle Beach, SC 29588-6028
Phone (843) 798-2837
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361232000000",
"number": "1124368733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 RIVER BEND RD",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295886028",
"telephone_number": "843-798-2837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4736 HIGHWAY 17 BYP S",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295885616",
"telephone_number": "843-444-9355",
"fax_number": "843-294-0019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELEY",
"first_name": "BRENDA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-19",
"last_updated": "2013-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "SC",
"license": "8012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.