NPIMap

Organization Active NPI

Fire & Ice Therapeutic Massage,LLC

  • Massage Therapist
  • Mint Hill, NC
National Provider Identifier
1154815439
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
14844 Issued in NC
Legal business name
FIRE & ICE THERAPEUTIC MASSAGE,LLC
Practice address
4732 Lebanon Rd
Suite a
Mint Hill, NC 28227-9112
Phone
(704) 763-2059
Fax
(980) 317-8495
NPI assigned
Jun 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Authorized official

Name
Ashley Smith Dwyer, LMBTNPI 1508350885
Title
Owner
Phone
(704) 763-2059

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 14844 NC Primary

Addresses

Primary practice location

4732 Lebanon Rd
Suite a
Mint Hill, NC 28227-9112

Mailing address

4732 Lebanon Rd
Suite a
Mint Hill, NC 28227-9112
Phone (704) 763-2059

Other practice location 1

4732 Lebanon Rd Ste D
Mint Hill, NC 28227-9112
Phone (704) 763-2059 ext. 70476

National Provider Directory

National Provider Directory

Locations

4732 Lebanon Rd
Ste A
Mint Hill, NC 28227
Phone (704) 763-2059

4732 Lebanon Rd
Ste D
Mint Hill, NC 28227
Phone (704) 763-2059

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1154815439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4732 LEBANON RD",
            "address_2": "SUITE A",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279112",
            "telephone_number": "704-763-2059",
            "fax_number": "980-317-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4732 LEBANON RD",
            "address_2": "SUITE A",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279112",
            "telephone_number": "704-763-2059",
            "fax_number": "980-317-8495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4732 Lebanon Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Mint Hill",
            "state": "NC",
            "postal_code": "282279112",
            "country_code": "US",
            "telephone_number": "704-763-2059 x70476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FIRE & ICE THERAPEUTIC MASSAGE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-19",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "SMITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-763-2059",
        "authorized_official_credential": "LMBT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "14844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mint Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.