Ellen Kathleen Budny, MT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT005177 Issued in GA

Practice address

505 US Highway 80 W
Pooler, GA 31322-2190

Phone

(914) 450-4044

NPI assigned

Oct 22, 2018

Last updated

Oct 22, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1144796715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 LONGLEAF CIR",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313229339",
            "telephone_number": "912-656-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 US HIGHWAY 80 W",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222190",
            "telephone_number": "914-450-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDNY",
        "first_name": "ELLEN",
        "middle_name": "KATHLEEN",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT005177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Pooler, GA
• Providers in Pooler, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.