Individual provider Active NPI

Randy Cabil, MASSAGE THERAPIST

  • Massage Therapist
  • Lawrenceville, GA
National Provider Identifier
1487174223
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MTO10435 Issued in GA
Practice address
333 Swanson Dr Ste 102
Lawrenceville, GA 30043-8537
Phone
(678) 878-3069
Fax
(678) 878-4455
NPI assigned
Jun 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MTO10435 GA Primary

Addresses

Primary practice location

333 Swanson Dr Ste 102
Lawrenceville, GA 30043-8537

Mailing address

PO Box 490186
Lawrenceville, GA 30049-0004
Phone (678) 878-3069

Other practice location 1

3400 McClure Bridge Rd Ste C304
Duluth, GA 30096-8706
Phone (678) 878-3069

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
MTO10435GAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Total Health Connection LLC CurrentSince Feb 21, 2021 Accepting new patients

Locations

3400 McClure Bridge Rd
Ste C304
Duluth, GA 30096
Phone (678) 878-3069

333 Swanson Dr
Ste 102
Lawrenceville, GA 30043
Phone (678) 878-3069

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": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1487174223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490186",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300490004",
            "telephone_number": "678-878-3069",
            "fax_number": "678-878-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SWANSON DR STE 102",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300438537",
            "telephone_number": "678-878-3069",
            "fax_number": "678-878-4455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 McClure Bridge Rd Ste C304",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300968706",
            "country_code": "US",
            "telephone_number": "678-878-3069",
            "fax_number": "678-878-4455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CABIL",
        "first_name": "RANDY",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MTO10435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.