Lily Duan

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT009921 Issued in GA

Practice address

10900 Medlock Bridge Rd Ste 101a
Johns Creek, GA 30097-1505

Phone

(470) 628-4065

NPI assigned

Mar 24, 2022

Last updated

Mar 24, 2022By the provider in NPPES

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1356091417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 WILLOWSTONE DR",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964013",
            "telephone_number": "718-885-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 MEDLOCK BRIDGE RD STE 101A",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971505",
            "telephone_number": "470-628-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUAN",
        "first_name": "LILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT009921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPIST",
            "identifier": "MT009921",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.one-stopspa.com",
            "affiliation": "N",
            "address_1": "10900 Medlock Bridge Rd Ste 101A",
            "city": "Johns Creek",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300971505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brian John Dowd, DDS
• Ria Alexander Dowell, NP
• Dejane Dozier, CNM
• Melissa Drane, MSCCCSLP
• Matthew Driscoll, PA-C, ATC, CSCS
• Martin Barry Duke, M.D.
• Richard G Dukes, MD
• Taylor Harrison Dukes
• Duluth Regenerative and Joint Institute LLC (Restore First Health)
• Duluth Surgery Center

• Massage Therapist in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.