Christine C Wilson, LMT NCTMB

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2014012307 Issued in MO

Practice address

9103 Phoenix Village Pkwy
Heart Centered Massage
O Fallon, MO 63368-4279

Phone

(630) 338-5408

NPI assigned

Jun 22, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1215319637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 AVENTURA WAY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633765927",
            "telephone_number": "630-338-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9103 PHOENIX VILLAGE PKWY",
            "address_2": "HEART CENTERED MASSAGE",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633684279",
            "telephone_number": "630-338-5408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHRISTINE",
        "middle_name": "C",
        "credential": "LMT NCTMB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MO",
            "license": "2014012307",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227014605",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael A Williams, DC
• Rachel Williams I, DPT
• Scott G Williams, M.D.
• Heather Carolyn Williamson, DO
• Willow Tree Mental Health Center, LLC
• Jennifer Leah Wilson
• Jennifer Susan Wilson, SLP
• Kalissa Lynn Wilson, MS CCC-SLP
• Katelynn Wilson
• Margaret Ann Wilson, CCC SLP

• Massage Therapist in O Fallon, MO
• Providers in O Fallon, MO by specialty
• Massage Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.