Outerbanks Massage With Goulet (Omg)

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

14500 Issued in NC

Legal business name

OUTERBANKS MASSAGE WITH GOULET (OMG)

Practice address

12 Juniper TRL Ste 203
Southern Shores, NC 27949-3745

Phone

(252) 305-0285

NPI assigned

Mar 8, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Barbara Lee Goulet, BMBT, MMP

Title

Medical Massage Practitioner

Phone

(252) 305-0285

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1144760273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 JUNIPER TRL STE 203",
            "city": "SOUTHERN SHORES",
            "state": "NC",
            "postal_code": "279493745",
            "telephone_number": "252-305-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 JUNIPER TRL STE 203",
            "city": "SOUTHERN SHORES",
            "state": "NC",
            "postal_code": "279493745",
            "telephone_number": "252-305-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTERBANKS MASSAGE WITH GOULET (OMG)",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "GOULET",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MEDICAL MASSAGE PRACTITIONER",
        "authorized_official_telephone_number": "252-305-0285",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BMBT, MMP"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NC",
            "license": "14500",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NC",
            "license": "14500",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NC",
            "license": "14500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Craig W McGiffin, D.C
• Donald Eugene McGriff, D.C.
• North Carolina CVS Pharmacy LLC (CVS Pharmacy #03112)
• Amy Morgan Robinson, PT
• Bonnie Roorda, PHD, ATC
• Marie Luise Shelton, LCMHCA
• Natalie Terryberry

• Point of Service in Southern Shores, NC
• Providers in Southern Shores, NC by specialty
• Point of Service in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.