Individual provider Active NPI

Heather A Tynes

  • Massage Therapist
  • Centereach, NY
National Provider Identifier
1730998907
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
021478 Issued in NY
Practice address
2364 Middle Country Rd
Centereach, NY 11720-3502
Phone
(516) 279-8876
NPI assigned
Jan 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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 021478 NY Primary

Addresses

Primary practice location

2364 Middle Country Rd
Centereach, NY 11720-3502

Mailing address

2364 Middle Country Rd
Centereach, NY 11720-3502
Phone (516) 279-8876

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
021478NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1730998907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 MIDDLE COUNTRY RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203502",
            "telephone_number": "516-279-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 MIDDLE COUNTRY RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203502",
            "telephone_number": "516-279-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNES",
        "first_name": "HEATHER",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "021478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centereach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2025; 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.