Individual provider Active NPI

Courtney Louallen, LMBT

  • Massage Therapist
  • Columbia, SC
National Provider Identifier
1689287401
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
9108 Issued in SC
Practice address
9367 Two Notch Rd Ste a
Columbia, SC 29223-6450
Phone
(803) 429-8680
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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 9108 SC Primary

Addresses

Primary practice location

9367 Two Notch Rd Ste a
Columbia, SC 29223-6450

Mailing address

9367 Two Notch Rd Ste a
Columbia, SC 29223-6450
Phone (803) 429-8680

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
9108SCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1689287401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9367 TWO NOTCH RD STE A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236450",
            "telephone_number": "803-429-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9367 TWO NOTCH RD STE A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236450",
            "telephone_number": "803-429-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUALLEN",
        "first_name": "COURTNEY",
        "credential": "LMBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "SC",
            "license": "9108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.