Individual provider Active NPI

Alejandro Lopez-Gavilan, LMT

  • Massage Therapist
  • Charlotte, NC
National Provider Identifier
1629945787
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
21390 Issued in NC
Practice address
2110 Courtside LN Apt 306
Charlotte, NC 28270-3336
Phone
(786) 675-0166
NPI assigned
Oct 22, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 21390 NC Primary

Addresses

Primary practice location

2110 Courtside LN Apt 306
Charlotte, NC 28270-3336

Mailing address

2110 Courtside LN Apt 306
Charlotte, NC 28270-3336
Phone (786) 675-0166

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
21390NCMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1629945787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 COURTSIDE LN APT 306",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282703336",
            "telephone_number": "786-675-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 COURTSIDE LN APT 306",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282703336",
            "telephone_number": "786-675-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-GAVILAN",
        "first_name": "ALEJANDRO",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "21390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.