Candace Miyori Minor

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2004 Issued in MS

Practice address

4280 Harlow Blvd
Greenville, MS 38701-6604

Phone

(662) 390-4920

NPI assigned

Apr 10, 2023

Last updated

Apr 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Candace Miyori Macon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• The Magnolia Day Spa LLC

  • Massage Therapist
  • Greenville, MS
  • NPI 1982399564
  NPD Authorized official

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1255026837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 HARLOW BLVD",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387016604",
            "telephone_number": "662-390-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 HARLOW BLVD",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387016604",
            "telephone_number": "662-390-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "CANDACE",
        "middle_name": "MIYORI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MS",
            "license": "2004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDACE",
            "last_name": "MACON",
            "middle_name": "MIYORI",
            "credential": "LMT #2004",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Massage Therapist in Greenville, MS
• Providers in Greenville, MS by specialty
• Massage Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.