Mandi Sue Weiser, LMT

Key facts

NPI

1831783661

Entity type

Individual (NPI type 1)

Primary specialty

Massage Therapist 225700000X

License

061575 (OH)

Practice address

173 Lumina PL
Holly Springs, NC 27540-8311

Phone

(740) 319-1479

NPI assigned

Feb 23, 2021

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 23, 2021.

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1831783661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 LUMINA PL",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275408311",
            "telephone_number": "740-319-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 LUMINA PL",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275408311",
            "telephone_number": "740-319-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISER",
        "first_name": "MANDI",
        "middle_name": "SUE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "061575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Holly Springs, NC · Massage Therapist in North Carolina