Red Stargazer

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

M04834 Issued in MD

Legal business name

RED STARGAZER

Practice address

2005 Rock Spring Rd
Suite 3
Forest Hill, MD 21050-2621

Phone

(410) 638-6774

NPI assigned

Jul 18, 2016

Organization subpart

No

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

Authorized official

Name

Miss Vickie Lynn Benz, LMT, CMMP

Title

Owner, Licensed Massage Therapist

Phone

(410) 638-6774

Specialties & licenses 1

Addresses

Other names 1

• My Happy Place Doing business as

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1386097178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 ROCK SPRING RD",
            "address_2": "SUITE 3",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502621",
            "telephone_number": "410-638-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 ROCK SPRING RD",
            "address_2": "SUITE 3",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502621",
            "telephone_number": "410-638-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED STARGAZER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "BENZ",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER, LICENSED MASSAGE THERAPIST",
        "authorized_official_telephone_number": "410-638-6774",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LMT, CMMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "MD",
            "license": "M04834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Happy Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracie Lynn Pridgeon, PT
• Austin Pucci, RBT
• Mia Puopolo, LAT, ATC
• Alisha Ramsey, LCPC
• Jacalyn Renee Reagan, OTR/L
• Rehabclinics (SPT), Inc.
• Bella Reina
• Joseph Anthony Reinhardt, M.D.
• Kaitlyn Reisinger
• Richard J Renehan Jr., P.T.

• Massage Therapist in Forest Hill, MD
• Providers in Forest Hill, MD by specialty
• Massage Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.