Still Waters Msssage

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2926 Issued in AL

Legal business name

STILL WATERS MSSSAGE

Practice address

1800 W Cummings Ave
Opp, AL 36467

Phone

(334) 493-4357

Fax

(334) 493-3836

NPI assigned

Oct 16, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kellie Victoria King, LMTNPI 1609245034

Title

Licensed Massage Therpist

Phone

(334) 343-6325

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kellie Victoria King, L.M.T.

  • Massage Therapist
  • Opp, AL
  • NPI 1609245034
  NPD (past) Authorized official

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444953600000",
    "number": "1699146548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W CUMMINGS AVE",
            "city": "OPP",
            "state": "AL",
            "postal_code": "36467",
            "telephone_number": "334-493-4357",
            "fax_number": "334-493-3836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W CUMMINGS AVE",
            "city": "OPP",
            "state": "AL",
            "postal_code": "36467",
            "telephone_number": "334-493-4357",
            "fax_number": "334-493-3836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILL WATERS MSSSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-16",
        "last_updated": "2015-10-16",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "LICENSED MASSAGE THERPIST",
        "authorized_official_telephone_number": "334-343-6325",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "AL",
            "license": "2926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1609245034",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AL LICENSE NUMBER FOR MASSAGE",
            "identifier": "2926",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southland Hospitalist at Opp, PLLC
• Southland Medical Solutions of Opp PLLC
• Jonathan Michael Stanfield, M.D.
• Lori Livingston Stanfield, M.D.
• Still Waters Adult Day Facility
• Tara Stinson
• Charles Loftin Studstill Jr., PHARMD
• Stormie Suhre
• Sycamore Physicians LLC
• T & C Pharmacy Inc

• Massage Therapist in Opp, AL
• Providers in Opp, AL by specialty
• Massage Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; 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.