Active NPI
Kanique Shanta Miree, LMBT
- Massage Therapist
- Cary, NC
National Provider Identifier
1689388902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 19142
- Practice address
- 1230 SE Maynard Rd Ste 203
Cary, NC 27511-6945 - Phone
- (919) 520-5868
- NPI assigned
- Jan 11, 2023
- 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 | 19142 | NC | Primary |
Addresses
Primary practice location
1230 SE Maynard Rd Ste 203
Cary, NC 27511-6945
Mailing address
1230 SE Maynard Rd Ste 203
Cary, NC 27511-6945
Phone (919) 520-5868
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | kneadedmassage.simplybook.it | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 19142 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1689388902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 SE MAYNARD RD STE 203",
"city": "CARY",
"state": "NC",
"postal_code": "275116945",
"telephone_number": "919-520-5868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 SE MAYNARD RD STE 203",
"city": "CARY",
"state": "NC",
"postal_code": "275116945",
"telephone_number": "919-520-5868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIREE",
"first_name": "KANIQUE",
"middle_name": "SHANTA",
"credential": "LMBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-11",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "19142",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "kneadedmassage.simplybook.it",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "1230 SE Maynard Rd Ste 203",
"city": "Cary",
"state": "NC",
"country_code": "US",
"postal_code": "275116945",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.