Tammy Pack, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT009777 Issued in GA

Practice address

420 N Columbia Ave
Rincon, GA 31326-6806

Phone

(912) 826-3624

NPI assigned

Aug 26, 2014

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

Practice roles

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.

• Serenity & Body Wellness LLC

  • Massage Therapist
  • Rincon, GA
  • NPI 1740633692
  NPD (past) Authorized official

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1265832307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2255",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313262255",
            "telephone_number": "912-826-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N COLUMBIA AVE",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313266806",
            "telephone_number": "912-826-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "TAMMY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT009777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John W Odom, MD
• Teresa Lynn Oglesbee, LPC
• Optim Orthopedics, LLC
• Our Therapy Place, LLC
• Tracey Embly Pace, TH.D.
• Raelynn M Padilla Hampton, RBT
• Kenyanna Parrish
• Deborah Patalano, OTR/L, LMT
• Bhumin Patel
• Hiral F Patel

• Massage Therapist in Rincon, GA
• Providers in Rincon, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.