Individual provider Active NPI

Amanda Jean Moretz Starr, LMT

  • Massage Therapist
  • Lilburn, GA
National Provider Identifier
1306281159
Registry record updated May 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
008804 Issued in GA
Practice address
4595 Canda Dr NW
Lilburn, GA 30047-3567
Phone
(404) 645-4469
NPI assigned
May 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 008804 GA Primary

Addresses

Primary practice location

4595 Canda Dr NW
Lilburn, GA 30047-3567

Mailing address

4595 Canda Dr NW
Lilburn, GA 30047-3567
Phone (404) 645-4469

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

LicenseStateTypeSpecialty
008804GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1306281159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4595 CANDA DR NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473567",
            "telephone_number": "404-645-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4595 CANDA DR NW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473567",
            "telephone_number": "404-645-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARR",
        "first_name": "AMANDA",
        "middle_name": "JEAN MORETZ",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "008804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; 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.