Stacy Allgood-Smith, LMT

Individual provider Active NPI Massage Therapist · Frederick, MD

NPI 1174873004 · NPPES record last updated Sep 18, 2012

Key facts

NPI
1174873004
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
M04621 (MD)
Practice address
1780 N Market St
Unit B
Frederick, MD 21701-4300
Phone
(301) 378-0334
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
M04621MDMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
RS Joint Venture LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X M04621 MD Yes

Addresses

Primary practice location

1780 N Market St
Unit B
Frederick, MD 21701-4300

Mailing address

1715 W 7TH St Apt 7
Frederick, MD 21702-4285
Phone (240) 446-2210

Other providers in Frederick, MD

All providers in Frederick, MD · Massage Therapist in Maryland

Sources for this page

Verify at the official NPI Registry.