Deziree Simms, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT132016 Issued in TX

Practice address

4887-1 Williams Drive
Suite 107
Georgetown, TX 78633

Phone

(512) 639-2769

NPI assigned

Nov 4, 2022

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

• Deziree Blankenship Former name

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.

• Georgetown Professional Massage and Wellness LLC

  • Massage Therapist
  • Georgetown, TX
  • NPI 1851008114
  NPD Authorized official

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1285341602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4887-1 WILLIAMS DRIVE",
            "address_2": "SUITE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78633",
            "telephone_number": "512-639-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4887-1 WILLIAMS DRIVE",
            "address_2": "SUITE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78633",
            "telephone_number": "512-639-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMS",
        "first_name": "DEZIREE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-04",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT132016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEZIREE",
            "last_name": "BLANKENSHIP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Asmath Siddiqui, MOT, OTR
• Eleno Sigarroa Silva
• Megan Lynne Silker, MSN, CPNP
• Carla Simard, PHARMD
• Dana Lee Simmang, M.D.
• Simply Mindful Therapy LLC
• Tracy Anne Simpson, LPC
• Chloe Allyson Sinclair, APRN-CNP
• Logan Taylor Sine
• Archana Singh, M.D

• Massage Therapist in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.