Brandywine Bodywork

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT0004411 Issued in DE

Legal business name

BRANDYWINE BODYWORK

Practice address

1400 Philadelphia Pike
Wilmington, DE 19809-1856

Phone

(302) 798-0801

Fax

(302) 798-3127

NPI assigned

Oct 20, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Marie Shahan, LMT

Title

Owner

Phone

(302) 798-0801

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476921600000",
    "number": "1669923058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PHILADELPHIA PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198091856",
            "telephone_number": "302-798-0801",
            "fax_number": "302-798-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PHILADELPHIA PIKE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198091856",
            "telephone_number": "302-798-0801",
            "fax_number": "302-798-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDYWINE BODYWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-10-20",
        "status": "A",
        "authorized_official_last_name": "SHAHAN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-798-0801",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "DE",
            "license": "MT0004411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Brand
• Kristina Brandis, LCSW
• Lynsey Ellen Brandt, MD
• Sarah Brandt
• Brandywine Area Nutrition, LLC
• Brandywine Care,LLC
• Brandywine Center for Autism, LLC
• Brandywine Center for Wellness
• Brandywine Chiropractic
• Brandywine Convalescent Home, Inc.

• Massage Therapist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Massage Therapist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.