Active NPI
Michael David Benavidez, L.M.T., M.M.P.
- Massage Therapist
- Mount Pleasant, SC
National Provider Identifier
1689015612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAS.8495R
- Practice address
- 1204 Landau LN
Mount Pleasant, SC 29466-7301 - Phone
- (817) 602-7922
- NPI assigned
- Jul 6, 2013
- Last updated
- Jul 6, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAS.8495R | SC | Primary |
| Massage Therapist | 225700000X | MT109593 | TX |
Addresses
Primary practice location
1204 Landau LN
Mount Pleasant, SC 29466-7301
Mailing address
1204 Landau LN
Mount Pleasant, SC 29466-7301
Phone (817) 602-7922
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 |
|---|---|---|---|
| MAS.8495R | SC | MD | Massage Therapist |
| MT109593 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373068800000",
"number": "1689015612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 LANDAU LN",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294667301",
"telephone_number": "817-602-7922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 LANDAU LN",
"city": "MOUNT PLEASANT",
"state": "SC",
"postal_code": "294667301",
"telephone_number": "817-602-7922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENAVIDEZ",
"first_name": "MICHAEL",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "L.M.T., M.M.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-06",
"last_updated": "2013-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "SC",
"license": "MAS.8495R",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT109593",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Pleasant, SC
- Bella Vita Psychotherapy Group, LLC
- Belle Hall Chiropractic Services, LLC (Belle Hall Chiropractic)
- Belle Hall Chiropractic, LLC
- Belle Hall Dentistry, LLC (Belle Hall Dentistry)
- Belle Hall Family Dentistry
- Benchmark Healthcare Services LLC
- Schuyler Renee Benjamin, DC
- Dylan Patrick Benke, PA-S
- Carole Bennett, PH.D,RN,CS
- Myriem Benzouina, LANGUAGE INTERPRETER
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.