Active NPI
Brandi Nachole Runyon, LMT
- Massage Therapist
- Williamson, WV
National Provider Identifier
1568928208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2009-2556
- Practice address
- 183 E 2ND Ave
Williamson, WV 25661-3601 - Phone
- (304) 928-3018
- NPI assigned
- Feb 19, 2019
- 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 | 2009-2556 | WV | Primary |
Addresses
Primary practice location
183 E 2ND Ave
Williamson, WV 25661-3601
Mailing address
767 Dans Branch Rd
Williamson, WV 25661-9122
Phone (304) 235-2574
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 |
|---|---|---|---|
| 2009-2556 | WV | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550534400000",
"number": "1568928208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "767 DANS BRANCH RD",
"city": "WILLIAMSON",
"state": "WV",
"postal_code": "256619122",
"telephone_number": "304-235-2574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "183 E 2ND AVE",
"city": "WILLIAMSON",
"state": "WV",
"postal_code": "256613601",
"telephone_number": "304-928-3018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNYON",
"first_name": "BRANDI",
"middle_name": "NACHOLE",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-19",
"last_updated": "2019-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WV",
"license": "2009-2556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamson, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.