Active NPI
David Phillips, KINESIOLOGIST, LMT
- Massage Therapist
- Charlotte, NC
National Provider Identifier
1396694915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 4499
- Practice address
- 820 Tyvola Rd Ste 203
Charlotte, NC 28217-3649 - Phone
- (980) 292-1090
- NPI assigned
- Jan 26, 2026
- Sex
- Male
- 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 | 4499 | NC | Primary |
Addresses
Primary practice location
820 Tyvola Rd Ste 203
Charlotte, NC 28217-3649
Mailing address
4619 Rockford CT
Charlotte, NC 28209-2922
Phone (704) 458-0268
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 |
|---|---|---|---|
| 4499 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Body Heal Therapy | Single Specialty | Current | Accepting new patients |
Locations
820 Tyvola Rd
Ste 203
Charlotte, NC 28217
Phone (980) 292-1090
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": "1769385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769385600000",
"number": "1396694915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4619 ROCKFORD CT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282092922",
"telephone_number": "704-458-0268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 TYVOLA RD STE 203",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282173649",
"telephone_number": "980-292-1090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "DAVID",
"name_prefix": "Mr.",
"credential": "KINESIOLOGIST, LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-01-26",
"last_updated": "2026-01-26",
"certification_date": "2026-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "NC",
"license": "4499",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.