NPIMap

Organization Active NPI

Sweetwater Life, LLC

  • Massage Therapist
  • Atlanta, GA
National Provider Identifier
1790201044
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT008978 Issued in GA
Legal business name
SWEETWATER LIFE, LLC
Practice address
1117 McGill Park Ave NE
Atlanta, GA 30312-4221
Phone
(404) 734-8853
NPI assigned
Aug 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Lekeisha Marquis Jones, LMTNPI 1336698331
Title
Owner
Phone
(404) 734-8853

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ReflexologistGroup: 193200000X MULTI-SPECIALTY GROUP 173C00000X MT008978 GA
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MT008978 GA Primary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X GA

Addresses

Primary practice location

1117 McGill Park Ave NE
Atlanta, GA 30312-4221

Mailing address

1117 McGill Park Ave NE
Atlanta, GA 30312-4221
Phone (404) 734-8853

Other identifiers 1

IdentifierTypeStateIssuer
MT008978OtherGAMASSAGE THERAPY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1790201044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 MCGILL PARK AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303124221",
            "telephone_number": "404-734-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 MCGILL PARK AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303124221",
            "telephone_number": "404-734-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEETWATER LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "LEKEISHA",
        "authorized_official_middle_name": "MARQUIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-734-8853",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Reflexologist",
            "state": "GA",
            "license": "MT008978",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT008978",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPY",
            "identifier": "MT008978",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.