Active NPI
Kiesha Brown, NCLMBT# 13715
- Massage Therapist
- Durham, NC
National Provider Identifier
1295506467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 13715
- Practice address
- 5007 Southpark Dr Ste 130
Durham, NC 27713-7739 - Phone
- (919) 572-2312
- NPI assigned
- Jan 15, 2024
- 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 | 13715 | NC | Primary |
Addresses
Primary practice location
5007 Southpark Dr Ste 130
Durham, NC 27713-7739
Mailing address
1014B E Geer St
Durham, NC 27704-5023
Phone (919) 599-8534
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 |
|---|---|---|---|
| 13715 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705276800000",
"number": "1295506467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1014B E GEER ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277045023",
"telephone_number": "919-599-8534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5007 SOUTHPARK DR STE 130",
"city": "DURHAM",
"state": "NC",
"postal_code": "277137739",
"telephone_number": "919-572-2312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "KIESHA",
"credential": "NCLMBT# 13715",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-15",
"last_updated": "2024-01-15",
"certification_date": "2024-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "13715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.