Active NPI
Keyera Mack
- Massage Therapist
- Myrtle Beach, SC
National Provider Identifier
1760334395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 12053
- Practice address
- 4025 N Kings Hwy
Myrtle Beach, SC 29577-2739 - Phone
- (843) 444-9095
- NPI assigned
- Feb 14, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 12053 | SC | Primary |
Addresses
Primary practice location
4025 N Kings Hwy
Myrtle Beach, SC 29577-2739
Mailing address
3605 Highway 472
Conway, SC 29526-6325
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 |
|---|---|---|---|
| 12053 | SC | MD | Developmental - Behavioral Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1771027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771027200000",
"number": "1760334395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 HIGHWAY 472",
"city": "CONWAY",
"state": "SC",
"postal_code": "295266325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 N KINGS HWY",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295772739",
"telephone_number": "843-444-9095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "KEYERA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-02-14",
"last_updated": "2026-02-14",
"certification_date": "2026-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "SC",
"license": "12053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.