Skyler John Doherty, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT008933 Issued in GA

Practice address

1147 U.S. Hwy 80
Pooler, GA 31322

Phone

(912) 748-1506

Fax

(912) 748-1507

NPI assigned

Nov 14, 2013

Last updated

Nov 14, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1740610567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 HARRIS TRAIL RD APT 2G",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313244243",
            "telephone_number": "912-484-2177",
            "fax_number": "912-748-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 U.S. HWY 80",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "31322",
            "telephone_number": "912-748-1506",
            "fax_number": "912-748-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "SKYLER",
        "middle_name": "JOHN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-14",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT008933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Pooler, GA
• Providers in Pooler, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; 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.