Individual provider Active NPI

Gregory Jemison

  • Massage Therapist
  • Lithia Springs, GA
National Provider Identifier
1508441619
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT010313 Issued in GA
Practice address
870 Crestmark Dr
Lithia Springs, GA 30122-2665
Phone
(770) 948-8000
NPI assigned
Mar 10, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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 MT010313 GA Primary

Addresses

Primary practice location

870 Crestmark Dr
Lithia Springs, GA 30122-2665

Mailing address

4113 Jewell Ter
Conley, GA 30288-1963
Phone (404) 784-1766

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
MT010313GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1508441619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 JEWELL TER",
            "city": "CONLEY",
            "state": "GA",
            "postal_code": "302881963",
            "telephone_number": "404-784-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 CRESTMARK DR",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301222665",
            "telephone_number": "770-948-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEMISON",
        "first_name": "GREGORY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT010313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.