Active NPI
Keyona Tyese Wise
- Massage Therapist
- Bluffton, SC
National Provider Identifier
1275130676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAS5571
- Practice address
- 108 Pine Ridge Dr
Bluffton, SC 29910-6815 - Phone
- (843) 338-8644
- NPI assigned
- Oct 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAS5571 | SC | Primary |
Addresses
Primary practice location
108 Pine Ridge Dr
Bluffton, SC 29910-6815
Mailing address
29 Brown Rd
Yemassee, SC 29945-7800
Phone (843) 338-8644
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
| License | State | Type | Specialty |
|---|---|---|---|
| MAS5571 | SC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602115200000",
"number": "1275130676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 BROWN RD",
"city": "YEMASSEE",
"state": "SC",
"postal_code": "299457800",
"telephone_number": "843-338-8644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 PINE RIDGE DR",
"city": "BLUFFTON",
"state": "SC",
"postal_code": "299106815",
"telephone_number": "843-338-8644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "KEYONA",
"middle_name": "TYESE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-08",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "SC",
"license": "MAS5571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bluffton, SC
- Anne Marie Willmann, APN
- Jennifer Wilson
- John Charles Winnestaffer, DC
- Winning Orthodontic Smiles LLC
- Ashley Davis Winters, M.S.-CCC-SLP
- Christopher Louis Wixon, M.D.
- Theodore W Wojcik, MD
- Adam Scott Wolters, D.D.S.
- Women's Health & Orthopedics, LLC (WHO PT, Veritas Physical Therapy)
- Jeffrey Scott Wonder, DMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.