Individual provider Active NPI

Kimberly Solomon, LMT

  • Massage Therapist
  • Warner Robins, GA
National Provider Identifier
1396598314
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT003665 Issued in GA
Practice address
2811 Watson Blvd Ste 3
Warner Robins, GA 31093-8594
Phone
(784) 971-4110
Fax
(478) 971-4072
NPI assigned
Apr 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X MT003665 GA Primary

Addresses

Primary practice location

2811 Watson Blvd Ste 3
Warner Robins, GA 31093-8594

Mailing address

2811 Watson Blvd Ste 3
Warner Robins, GA 31093-8594
Phone (478) 971-4110

Other practice location 1

2811 Watson Blvd Ste 3
Warner Robins, GA 31093-8594
Phone (784) 971-4110

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
MT003665GAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Care & Rehabilitation, LLC Single Specialty CurrentSince Apr 14, 2024 Accepting new patients

Locations

2811 Watson Blvd
Ste 3
Warner Robins, GA 31093
Phone (478) 971-4110

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1396598314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WATSON BLVD STE 3",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310938594",
            "telephone_number": "478-971-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WATSON BLVD STE 3",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310938594",
            "telephone_number": "784-971-4110",
            "fax_number": "478-971-4072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2811 Watson Blvd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310938594",
            "country_code": "US",
            "telephone_number": "784-971-4110",
            "fax_number": "478-971-4072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "KIMBERLY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT003665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.