Active NPI
Nikkia Raiford
- Massage Therapist
- Fayetteville, GA
National Provider Identifier
1306658596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT013426
- Practice address
- 101 Beckett LN Ste 303
Fayetteville, GA 30214-7158 - Phone
- (470) 895-2146
- NPI assigned
- Jan 23, 2025
- 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 | MT013426 | GA | Primary |
Addresses
Primary practice location
101 Beckett LN Ste 303
Fayetteville, GA 30214-7158
Mailing address
4879 Embarcadero LN Apt 28-12
Atlanta, GA 30337-6513
Phone (470) 895-2146
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 |
|---|---|---|---|
| MT013426 | GA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737590400000",
"number": "1306658596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4879 EMBARCADERO LN APT 28-12",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303376513",
"telephone_number": "470-895-2146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BECKETT LN STE 303",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147158",
"telephone_number": "470-895-2146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAIFORD",
"first_name": "NIKKIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-23",
"last_updated": "2025-01-23",
"certification_date": "2025-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "GA",
"license": "MT013426",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.