Active NPI
Stephanie Dunlap
- Massage Therapist
- Loganville, GA
National Provider Identifier
1689313611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 011124
- Practice address
- 299 Cooper Rd Ste B
Loganville, GA 30052-2579 - Phone
- (706) 250-1769
- NPI assigned
- May 28, 2022
- Sex
- Female
- 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 | 011124 | GA | Primary |
Addresses
Primary practice location
299 Cooper Rd Ste B
Loganville, GA 30052-2579
Mailing address
441 Saddle Shoal TRL
Lawrenceville, GA 30046-3188
Phone (470) 403-3987
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 |
|---|---|---|---|
| 011124 | GA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aos Healing Center, LLC | Massage Therapist | Current | Accepting new patients |
Locations
299 Cooper Rd
Ste B
Loganville, GA 30052
Phone (706) 250-1769
Organizations & group practices 1
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.
-
- Health Service Clinic/Center
- Loganville, GA
- NPI 1467102988
Massage Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653696000000",
"number": "1689313611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 SADDLE SHOAL TRL",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300463188",
"telephone_number": "470-403-3987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "299 COOPER RD STE B",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300522579",
"telephone_number": "706-250-1769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNLAP",
"first_name": "STEPHANIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-28",
"last_updated": "2022-05-28",
"certification_date": "2022-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "GA",
"license": "011124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.