Individual provider Active NPI

Bao The Trinh

  • Massage Therapist
  • Norcross, GA
National Provider Identifier
1649978131
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT010181 Issued in GA
Practice address
5955 Jimmy Carter Blvd Suite 40
Norcross, GA 30071
Phone
(404) 610-0158
Fax
(888) 551-2303
NPI assigned
Feb 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT010181 GA Primary

Addresses

Primary practice location

5955 Jimmy Carter Blvd Suite 40
Norcross, GA 30071

Mailing address

5955 Jimmy Carter Blvd Suite 40
Norcross, GA 30071
Phone (404) 610-0158

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
MT010181GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1649978131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5955 JIMMY CARTER BLVD SUITE 40",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "30071",
            "telephone_number": "404-610-0158",
            "fax_number": "888-551-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 JIMMY CARTER BLVD SUITE 40",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "30071",
            "telephone_number": "404-610-0158",
            "fax_number": "888-551-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRINH",
        "first_name": "BAO",
        "middle_name": "THE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT010181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.