East End Sports Massage

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

EAST END SPORTS MASSAGE

Practice address

222 Manor PL Ste 7
Greenport, NY 11944-1261

Phone

(631) 268-4769

NPI assigned

Aug 31, 2021

Organization subpart

No

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

Authorized official

Name

Nicole Kennelly, LMTNPI 1134512114

Title

Owner

Phone

(718) 683-1905

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Marie Kennelly, LMT

  • Massage Therapist
  • Greenport, NY
  • NPI 1134512114
  NPD Authorized official

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1154099570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 VILLAGE LN",
            "city": "ORIENT",
            "state": "NY",
            "postal_code": "119571469",
            "telephone_number": "718-683-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MANOR PL STE 7",
            "city": "GREENPORT",
            "state": "NY",
            "postal_code": "119441261",
            "telephone_number": "631-268-4769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST END SPORTS MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "KENNELLY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-683-1905",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynnlee Reese Duck-Reynolds, DO
• East End Bugee Transport LLC
• East End Cardiology PC
• East End Cardiology, PC
• East End Nephrology, PC
• Eastern Long Island Hospital Assoc Inc
• Eastern Long Island Hospital Assoc Inc
• Christopher M. Eten, RPA-C
• Francesca Ferrante
• Danielle Finne

• All providers in Greenport, NY
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.