Individual provider Active NPI

Keturah Daniel, LMT

  • Massage Therapist
  • Kennesaw, GA
National Provider Identifier
1174897680
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT002243 Issued in GA
Practice address
2481 Paulding St NW
Kennesaw, GA 30144-5647
Phone
(404) 512-9382
NPI assigned
Mar 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT002243 GA Primary

Addresses

Primary practice location

2481 Paulding St NW
Kennesaw, GA 30144-5647

Mailing address

2481 Paulding St NW
Kennesaw, GA 30144-5647
Phone (404) 512-9382

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MT002243GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1174897680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2481 PAULDING ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445647",
            "telephone_number": "404-512-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2481 PAULDING ST NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445647",
            "telephone_number": "404-512-9382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "KETURAH",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT002243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.