Active NPI
Beau Judson Willsey, LMBT
- Massage Therapist
- Cape Carteret, NC
National Provider Identifier
1689009151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 13564
- Practice address
- 211 WB McLean Dr
Cape Carteret, NC 28584-8515 - Phone
- (910) 915-9433
- NPI assigned
- Sep 3, 2013
- Sex
- Male
- 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 | 13564 | NC | Primary |
Addresses
Primary practice location
211 WB McLean Dr
Cape Carteret, NC 28584-8515
Mailing address
202 Coldwater Dr
Swansboro, NC 28584-8256
Phone (910) 915-9433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13564 | Other | NC | NC BOARD OF MASSAGE |
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 |
|---|---|---|---|
| 13564 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1378166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572566400000",
"number": "1689009151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 COLDWATER DR",
"city": "SWANSBORO",
"state": "NC",
"postal_code": "285848256",
"telephone_number": "910-915-9433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 WB MCLEAN DR",
"city": "CAPE CARTERET",
"state": "NC",
"postal_code": "285848515",
"telephone_number": "910-915-9433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLSEY",
"first_name": "BEAU",
"middle_name": "JUDSON",
"credential": "LMBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-09-03",
"last_updated": "2019-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "13564",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NC BOARD OF MASSAGE",
"identifier": "13564",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cape Carteret, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.