Active NPI
Amanda Henderson
- Massage Therapist
- Pennsauken, NJ
National Provider Identifier
1417562273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 3368 E Hollywood Cir
Pennsauken, NJ 08109-2307 - Phone
- (856) 340-2799
- NPI assigned
- Sep 9, 2020
- Last updated
- Sep 9, 2020
- 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 | Primary |
Addresses
Primary practice location
3368 E Hollywood Cir
Pennsauken, NJ 08109-2307
Mailing address
270 Mount Laurel Rd
Mount Laurel, NJ 08054
Other practice location 1
1671 Nixon drive
Moorestown, NJ 08054
Phone (856) 340-2799
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599609600000",
"number": "1417562273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "270 MOUNT LAUREL RD",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "08054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3368 E HOLLYWOOD CIR",
"city": "PENNSAUKEN",
"state": "NJ",
"postal_code": "081092307",
"telephone_number": "856-340-2799"
}
],
"practiceLocations": [
{
"address_1": "1671 Nixon drive",
"address_purpose": "LOCATION",
"city": "Moorestown",
"state": "NJ",
"postal_code": "08054",
"country_code": "US",
"telephone_number": "856-340-2799",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HENDERSON",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-09",
"last_updated": "2020-09-09",
"certification_date": "2020-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pennsauken, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.