Active NPI
Edith Anneliese Martin, NCLMT
- Massage Therapist
- Winchester, TN
National Provider Identifier
1821005489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 4767
- Practice address
- 164 Woodcrest Dr
Winchester, TN 37398-2349 - Phone
- (931) 636-0885
- Fax
- (931) 967-9050
- NPI assigned
- Aug 3, 2006
- Sex
- Female
- 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 | 4767 | TN | Primary |
Addresses
Primary practice location
164 Woodcrest Dr
Winchester, TN 37398-2349
Mailing address
164 Woodcrest Dr
Winchester, TN 37398-2349
Phone (931) 636-0885
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 |
|---|---|---|---|
| 4767 | TN | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821005489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 WOODCREST DR",
"city": "WINCHESTER",
"state": "TN",
"postal_code": "373982349",
"telephone_number": "931-636-0885",
"fax_number": "931-967-9050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "164 WOODCREST DR",
"city": "WINCHESTER",
"state": "TN",
"postal_code": "373982349",
"telephone_number": "931-636-0885",
"fax_number": "931-967-9050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "EDITH",
"middle_name": "ANNELIESE",
"name_prefix": "Mrs.",
"credential": "NCLMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TN",
"license": "4767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winchester, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.