Individual provider Active NPI

Belinda Mavis Garrett-Ibe, MASSAGE THERAPIST

  • Massage Therapist
  • Lawrenceville, GA
National Provider Identifier
1144516279
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT000740 Issued in GA
Practice address
3444 Club Dr
Lawrenceville, GA 30044-2402
Phone
(770) 771-2570
NPI assigned
Jun 27, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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 MT000740 GA Primary

Addresses

Primary practice location

3444 Club Dr
Lawrenceville, GA 30044-2402

Mailing address

1551 Park Grove Dr
Lawrenceville, GA 30046-4398
Phone (770) 771-2570

Other identifiers 1

IdentifierTypeStateIssuer
MT000740OtherGAGEORGIA MASSAGE THERAPIST LICENSE

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
MT000740GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1144516279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 PARK GROVE DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464398",
            "telephone_number": "770-771-2570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3444 CLUB DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300442402",
            "telephone_number": "770-771-2570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT-IBE",
        "first_name": "BELINDA",
        "middle_name": "MAVIS",
        "name_prefix": "Mrs.",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT000740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA MASSAGE THERAPIST LICENSE",
            "identifier": "MT000740",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; 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.