Body Kneads LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

2014-3228 Issued in WV

Legal business name

BODY KNEADS LLC

Practice address

19 Main Ave
Logan, WV 25601-3332

Phone

(304) 752-2220

Fax

(304) 752-3010

NPI assigned

Nov 30, 2015

Last updated

Nov 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joy Queen

Title

Office Manager

Phone

(304) 752-2220

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448841600000",
    "number": "1356715429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 MAIN AVE",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013332",
            "telephone_number": "304-752-2220",
            "fax_number": "304-752-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 MAIN AVE",
            "city": "LOGAN",
            "state": "WV",
            "postal_code": "256013332",
            "telephone_number": "304-752-2220",
            "fax_number": "304-752-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY KNEADS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-30",
        "last_updated": "2015-11-30",
        "status": "A",
        "authorized_official_last_name": "QUEEN",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-752-2220"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "WV",
            "license": "2014-3228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammi Endicott Blankenship, NP
• Travis Glenn Blanton, MD
• Andrea Bledsoe, CFNP
• Steven Block
• Bobbie Boatwright
• Sarah Boles
• Giles Bowman, CRNA
• Delorice Bragg
• Judith Brendemuehl, M.D.0
• Kevin Shawn Brewer

• Specialist in Logan, WV
• Providers in Logan, WV by specialty
• Specialist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.