Active NPI
Brandon Orlando Williams, CMT, LMT
- Massage Therapist
- Vienna, VA
National Provider Identifier
1609330877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 0019011599
- Practice address
- 307 Maple Ave W Ste L
Vienna, VA 22180-4307 - Phone
- (703) 672-1613
- NPI assigned
- Jan 22, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 0019011599 | VA | Primary |
Addresses
Primary practice location
307 Maple Ave W Ste L
Vienna, VA 22180-4307
Mailing address
307 Maple Ave W Ste L
Vienna, VA 22180-4307
Phone (703) 672-1613
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 |
|---|---|---|---|
| 0019011599 | VA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waterfalls Wellness Center LLC | Massage Therapist | Past | Accepting new patients |
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.
-
- Massage Therapist
- Vienna, VA
- NPI 1003370842
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1609330877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 MAPLE AVE W STE L",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804307",
"telephone_number": "703-672-1613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 MAPLE AVE W STE L",
"city": "VIENNA",
"state": "VA",
"postal_code": "221804307",
"telephone_number": "703-672-1613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "BRANDON",
"middle_name": "ORLANDO",
"credential": "CMT, LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-22",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "VA",
"license": "0019011599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.