Active NPI
Sandra Davis, L.M.T.
- Massage Therapist
- Kingston, PA
National Provider Identifier
1407129570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MSG001103
- Practice address
- 417 Market St
Kingston, PA 18704-5418 - Phone
- (570) 283-1011
- NPI assigned
- Feb 20, 2012
- Sex
- Female
- 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 | MSG001103 | PA | Primary |
Addresses
Primary practice location
417 Market St
Kingston, PA 18704-5418
Mailing address
417 Market St
Kingston, PA 18704-5418
Phone (570) 283-1011
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 |
|---|---|---|---|
| MSG001103 | PA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329696000000",
"number": "1407129570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 MARKET ST",
"city": "KINGSTON",
"state": "PA",
"postal_code": "187045418",
"telephone_number": "570-283-1011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 MARKET ST",
"city": "KINGSTON",
"state": "PA",
"postal_code": "187045418",
"telephone_number": "570-283-1011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SANDRA",
"name_prefix": "Mrs.",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-20",
"last_updated": "2012-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "PA",
"license": "MSG001103",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingston, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.