Active NPI
Kaffia Radiance Jennifer Gray
- Massage Therapist
- Gastonia, NC
National Provider Identifier
1710605399
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 20154
- Practice address
- 1812 Yellowstone CT Apt D
Gastonia, NC 28054-1738 - Phone
- (602) 502-4557
- NPI assigned
- Aug 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 20154 | NC | Primary |
| Doula | 374J00000X |
Addresses
Primary practice location
1812 Yellowstone CT Apt D
Gastonia, NC 28054-1738
Mailing address
1812 Yellowstone CT Apt D
Gastonia, NC 28054-1738
Phone (602) 502-4557
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 |
|---|---|---|---|
| 20154 | NC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660780800000",
"number": "1710605399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1812 YELLOWSTONE CT APT D",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280541738",
"telephone_number": "602-502-4557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1812 YELLOWSTONE CT APT D",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280541738",
"telephone_number": "602-502-4557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "KAFFIA",
"middle_name": "RADIANCE JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-18",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "20154",
"primary": true
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.