Danielle Lee Kvidera Mendez, LMP, MMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

14605 Issued in NC

Practice address

642 Kentucky Derby LN
Lillington, NC 27546-9742

Phone

(541) 218-0584

NPI assigned

Sep 15, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Danielle Lee Kvidera Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healing Hands Body Therapy

  • Massage Therapist
  • Fayetteville, NC
  • NPI 1982075149
  NPD (past)

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550361600000",
    "number": "1649503145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5843 RAMSEY ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283113467",
            "telephone_number": "910-818-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 KENTUCKY DERBY LN",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275469742",
            "telephone_number": "541-218-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDEZ",
        "first_name": "DANIELLE",
        "middle_name": "LEE KVIDERA",
        "name_prefix": "Mrs.",
        "credential": "LMP, MMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2019-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NC",
            "license": "14605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "KVIDERA",
            "middle_name": "LEE",
            "prefix": "MISS",
            "credential": "LMP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Lillington, NC
• Massage Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2019; 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.