Active NPI
Maurice Martin II, MT
- Massage Therapist
- Fayetteville, GA
National Provider Identifier
1811644792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 006654
- Practice address
- 1415 Highway 85 N Ste 310282
Fayetteville, GA 30214-7738 - Phone
- (404) 566-6475
- NPI assigned
- Mar 9, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | 006654 | GA | Primary |
Addresses
Primary practice location
1415 Highway 85 N Ste 310282
Fayetteville, GA 30214-7738
Mailing address
1415 Highway 85 N Ste 310282
Fayetteville, GA 30214-7738
Phone (404) 566-6475
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
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006654 | GA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677542400000",
"number": "1811644792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 HIGHWAY 85 N STE 310282",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147738",
"telephone_number": "404-566-6475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 HIGHWAY 85 N STE 310282",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147738",
"telephone_number": "404-566-6475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MAURICE",
"name_suffix": "II",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-09",
"last_updated": "2023-02-28",
"certification_date": "2023-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "GA",
"license": "006654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.