Active NPI
Janis C Pulliam, LMBT, NEPT
- Massage Therapist
- Wilmington, NC
National Provider Identifier
1639948631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 1379
- Practice address
- 5725 Oleander Dr Ste E5
Wilmington, NC 28403-4746 - Phone
- (910) 620-5765
- NPI assigned
- Jan 2, 2024
- 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 | 1379 | NC | Primary |
Addresses
Primary practice location
5725 Oleander Dr Ste E5
Wilmington, NC 28403-4746
Mailing address
5725 Oleander Dr Ste E5
Wilmington, NC 28403-4746
Phone (910) 620-5765
Other names 1
- Janis Pulliam
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 |
|---|---|---|---|
| 1379 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704153600000",
"number": "1639948631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5725 OLEANDER DR STE E5",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284034746",
"telephone_number": "910-620-5765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5725 OLEANDER DR STE E5",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284034746",
"telephone_number": "910-620-5765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PULLIAM",
"first_name": "JANIS",
"middle_name": "C",
"credential": "LMBT, NEPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-02",
"last_updated": "2024-01-02",
"certification_date": "2024-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "1379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JANIS",
"last_name": "PULLIAM",
"credential": "LMBT, NEPT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.