Individual provider Active NPI

Kathy Rosemary Menard, LMT

  • Massage Therapist
  • Woodstock, GA
National Provider Identifier
1619502606
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00181845 Issued in GA
Practice address
6884 Hickory Flat Hwy
Woodstock, GA 30188-3229
Phone
(404) 216-9337
NPI assigned
Mar 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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 MA00181845 GA Primary

Addresses

Primary practice location

6884 Hickory Flat Hwy
Woodstock, GA 30188-3229

Mailing address

213 Sundance Dr
Woodstock, GA 30188-3037
Phone (404) 216-9337

Other practice location 1

213 Sundance Dr
Woodstock, GA 30188-3037
Phone (404) 216-9337

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
MA00181845GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1619502606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 SUNDANCE DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883037",
            "telephone_number": "404-216-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6884 HICKORY FLAT HWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883229",
            "telephone_number": "404-216-9337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "213 Sundance Dr",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301883037",
            "country_code": "US",
            "telephone_number": "404-216-9337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENARD",
        "first_name": "KATHY",
        "middle_name": "ROSEMARY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MA00181845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.