Active NPI
Gina Booth, LMBT, MMT
- Massage Therapist
- Manteo, NC
National Provider Identifier
1619372273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 11661
- Practice address
- 711 N Hwy 64
Manteo, NC 27954 - Phone
- (252) 256-2717
- NPI assigned
- Oct 24, 2014
- Last updated
- Oct 24, 2014
- 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 | 11661 | NC | Primary |
Addresses
Primary practice location
711 N Hwy 64
Manteo, NC 27954
Mailing address
129 Dolphin Dr
Manteo, NC 27954-9102
Phone (252) 256-2717
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 |
|---|---|---|---|
| 11661 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414108800000",
"number": "1619372273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 DOLPHIN DR",
"city": "MANTEO",
"state": "NC",
"postal_code": "279549102",
"telephone_number": "252-256-2717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 N HWY 64",
"city": "MANTEO",
"state": "NC",
"postal_code": "27954",
"telephone_number": "252-256-2717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOOTH",
"first_name": "GINA",
"credential": "LMBT, MMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-24",
"last_updated": "2014-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "11661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manteo, NC
- Albemarle Mental Health Center
- Albemarle Nephrology PLLC
- Albemarle Physician Services - Sentara, Inc (Sentara Family Medicine Physicians)
- Barry Ira Aron, MD
- Deanne Carpenter Aron, RDN
- Kathleen Ann Brehony, PH.D.
- Melanie Cahoon, RPH
- Stephen Paul Cicinato, DDS
- Coastal Rehabilitation Inc
- Janice Fletcher Culpepper, LPC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.