NPIMap

Organization Active NPI

Advance Therapeutic Massage

  • Mechanotherapist
  • Clemson, SC
National Provider Identifier
1295058782
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
4650 Issued in SC
Legal business name
ADVANCE THERAPEUTIC MASSAGE
Practice address
402 Pendleton Rd
Suite 4
Clemson, SC 29631-2242
Phone
(864) 653-4177
NPI assigned
Mar 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Authorized official

Name
Mrs. Sherri Diane Fowler, NCTMB, LMTNPI 1750604245
Title
President
Phone
(864) 653-4177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MechanotherapistGroup: 193200000X MULTI-SPECIALTY GROUP 172M00000X 4650 SC Primary

Addresses

Primary practice location

402 Pendleton Rd
Suite 4
Clemson, SC 29631-2242

Mailing address

402 Pendleton Rd
Suite 4
Clemson, SC 29631
Phone (864) 653-4177

Other names 1

  • Fowler Karate Inc Former legal business name

National Provider Directory

National Provider Directory

Locations

402 Pendleton Rd
Ste 4
Clemson, SC 29631
Phone (864) 633-0210

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268265600000",
    "number": "1295058782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 PENDLETON RD",
            "address_2": "SUITE 4",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "29631",
            "telephone_number": "864-653-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 PENDLETON RD",
            "address_2": "SUITE 4",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312242",
            "telephone_number": "864-653-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE THERAPEUTIC MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-653-4177",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NCTMB, LMT"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Mechanotherapist",
            "state": "SC",
            "license": "4650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fowler Karate Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Clemson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.