Individual provider Active NPI

Celisa Monica Ellis, LMT

  • Massage Therapist
  • Goodlettsville, TN
National Provider Identifier
1124437066
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7924 Issued in TN
Practice address
907 Rivergate Pkwy Ste E4
Goodlettsville, TN 37072-2333
Phone
(615) 448-6446
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 7924 TN Primary

Addresses

Primary practice location

907 Rivergate Pkwy Ste E4
Goodlettsville, TN 37072-2333

Mailing address

907 Rivergate Pkwy Ste E4
Goodlettsville, TN 37072-2333
Phone (615) 448-6446

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
7924TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Promassage & Chiropractic Inc Massage Therapist Past Accepting new patients
Pro Massage & Chiropractic Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1124437066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 RIVERGATE PKWY STE E4",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370722333",
            "telephone_number": "615-448-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 RIVERGATE PKWY STE E4",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370722333",
            "telephone_number": "615-448-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CELISA",
        "middle_name": "MONICA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TN",
            "license": "7924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodlettsville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.

Verify at the official NPI Registry.