Individual provider Active NPI

Mark Kennon, LMT, HEALTH COACH

  • Massage Therapist
  • Mount Pleasant, SC
National Provider Identifier
1720442957
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7246 Issued in SC
Practice address
721 Long Point Rd
Ste 403
Mount Pleasant, SC 29464-8297
Phone
(843) 514-6731
NPI assigned
Apr 13, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 7246 SC Primary

Addresses

Primary practice location

721 Long Point Rd
Ste 403
Mount Pleasant, SC 29464-8297

Mailing address

721 Long Point Rd
Ste 403
Mount Pleasant, SC 29464-8297
Phone (843) 514-6731

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

LicenseStateTypeSpecialty
7246SCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1720442957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 LONG POINT RD",
            "address_2": "STE 403",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294648297",
            "telephone_number": "843-514-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 LONG POINT RD",
            "address_2": "STE 403",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294648297",
            "telephone_number": "843-514-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNON",
        "first_name": "MARK",
        "credential": "LMT, HEALTH COACH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "SC",
            "license": "7246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.