Individual provider Active NPI

Megan Kristine Runkel, LMP

  • Massage Therapist
  • Long Beach, MS
National Provider Identifier
1669619201
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
2645 Issued in MS
Practice address
125 Jeff Davis Ave
Long Beach, MS 39560-6134
Phone
(228) 313-9208
Fax
(228) 868-4991
NPI assigned
Jan 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 2645 MS Primary
Specialist 174400000X MA 60018937 WA

Addresses

Primary practice location

125 Jeff Davis Ave
Long Beach, MS 39560-6134

Mailing address

125 Jeff Davis Ave
Long Beach, MS 39560-6134
Phone (228) 313-9208

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
MA 60018937WAMDSpecialist
2645MSMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Miller-Whitmer Family Chiropractic CurrentSince Jan 19, 2020 Accepting new patients
Sunshine Healing Massage Therapist Current Accepting new patients

Locations

125 Jeff Davis Ave
Long Beach, MS 39560
Phone (228) 313-9208

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1669619201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 JEFF DAVIS AVE",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395606134",
            "telephone_number": "228-313-9208",
            "fax_number": "228-868-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 JEFF DAVIS AVE",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395606134",
            "telephone_number": "228-313-9208",
            "fax_number": "228-868-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNKEL",
        "first_name": "MEGAN",
        "middle_name": "KRISTINE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-20",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MS",
            "license": "2645",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA 60018937",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.