Active NPI
Jeanette Egan, NC LMBT 21580
- Massage Therapist
- Fayetteville, NC
National Provider Identifier
1649014812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 21580
- Practice address
- 4140 Ferncreek Dr Ste 702
Fayetteville, NC 28314-2569 - Phone
- (910) 514-6251
- NPI assigned
- Jun 22, 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 | 21580 | NC | Primary |
Addresses
Primary practice location
4140 Ferncreek Dr Ste 702
Fayetteville, NC 28314-2569
Mailing address
8435 NC Highway 42 S
Ramseur, NC 27316-8221
Phone (336) 209-9805
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 |
|---|---|---|---|
| 21580 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789084800000",
"number": "1649014812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8435 NC HIGHWAY 42 S",
"city": "RAMSEUR",
"state": "NC",
"postal_code": "273168221",
"telephone_number": "336-209-9805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4140 FERNCREEK DR STE 702",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283142569",
"telephone_number": "910-514-6251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGAN",
"first_name": "JEANETTE",
"credential": "NC LMBT 21580",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-22",
"last_updated": "2026-09-11",
"certification_date": "2026-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "21580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.