Active NPI
Charles George King Jr., LMT
- Massage Therapist
- Phoenix, AZ
National Provider Identifier
1700425949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT-09329
- Practice address
- 6223 N 20TH Dr
Phoenix, AZ 85015-1516 - Phone
- (480) 518-2090
- Fax
- (855) 518-2090
- NPI assigned
- Jan 6, 2020
- Sex
- Male
- Sole proprietor
- No
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 | MT-09329 | AZ | Primary |
Addresses
Primary practice location
6223 N 20TH Dr
Phoenix, AZ 85015-1516
Mailing address
3905 N 7TH Ave Unit 34965
Phoenix, AZ 85013-3368
Phone (480) 518-2090
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MT-09329 | Other | AZ | MASSAGE LICENSE |
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 |
|---|---|---|---|
| MT-09329 | AZ | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578268800000",
"number": "1700425949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3905 N 7TH AVE UNIT 34965",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850133368",
"telephone_number": "480-518-2090",
"fax_number": "855-518-2090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6223 N 20TH DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850151516",
"telephone_number": "480-518-2090",
"fax_number": "855-518-2090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "CHARLES",
"middle_name": "GEORGE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-01-06",
"last_updated": "2020-01-06",
"certification_date": "2020-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AZ",
"license": "MT-09329",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE LICENSE",
"identifier": "MT-09329",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.