Madeline H Chavis, LMT, MLDT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

04223 Issued in NC

Practice address

106 S Lombard St Ste 104
Clayton, NC 27520-2554

Phone

(919) 862-6815

NPI assigned

Oct 30, 2015

Last updated

Jan 13, 2020By 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)

Enrolled

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1154793081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S LOMBARD ST",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202554",
            "telephone_number": "919-862-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S LOMBARD ST STE 104",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202554",
            "telephone_number": "919-862-6815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 Walking Stick Trl",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276039275",
            "country_code": "US",
            "telephone_number": "919-697-9715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAVIS",
        "first_name": "MADELINE",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "LMT, MLDT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "04223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Clayton, NC
• Providers in Clayton, NC by specialty
• Massage Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; 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.