Active NPI
Dianna Carole Williams, MASSAGE THERAPIST
- Massage Therapist
- Waldorf, MD
National Provider Identifier
1134935364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- R02660
- Practice address
- 4140 Crain Hwy
Waldorf, MD 20603-4858 - Phone
- (910) 703-9569
- NPI assigned
- Dec 3, 2024
- 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 | R02660 | MD | Primary |
Addresses
Primary practice location
4140 Crain Hwy
Waldorf, MD 20603-4858
Mailing address
4530 Cavalier CT
White Plains, MD 20695-4403
Phone (910) 703-9569
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
| License | State | Type | Specialty |
|---|---|---|---|
| R02660 | MD | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733184000000",
"number": "1134935364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4530 CAVALIER CT",
"city": "WHITE PLAINS",
"state": "MD",
"postal_code": "206954403",
"telephone_number": "910-703-9569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4140 CRAIN HWY",
"city": "WALDORF",
"state": "MD",
"postal_code": "206034858",
"telephone_number": "910-703-9569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "DIANNA",
"middle_name": "CAROLE",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-03",
"last_updated": "2024-12-03",
"certification_date": "2024-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MD",
"license": "R02660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.