Active NPI
Dwayne T McKee, MASSAGE THERAPIST
- Massage Therapist
- Marrero, LA
National Provider Identifier
1841676608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 4090
- Practice address
- 5508 Niagara Dr
Marrero, LA 70072-4911 - Phone
- (504) 338-4253
- NPI assigned
- Aug 4, 2015
- Last updated
- Nov 5, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 4090 | LA | Primary |
| Massage Therapist | 225700000X | LA4090 | LA |
Addresses
Primary practice location
5508 Niagara Dr
Marrero, LA 70072-4911
Mailing address
5508 Niagara Dr
Marrero, LA 70072-4911
Phone (504) 338-4253
Other practice location 1
2600 Belle Chasse Hwy Ste 211
Gretna, LA 70056-7156
Phone (504) 338-4253
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4090 | Other | LA | LMT |
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 |
|---|---|---|---|
| 4090 | LA | MD | General Practice Dentistry |
| LA4090 | LA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dreamers Touch | Massage Therapist | Current | Accepting new patients |
Locations
1300 Barataria Blvd
Marrero, LA 70072
Phone (504) 338-4253
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Massage Therapist
- Marrero, LA
- NPI 1831940162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730764800000",
"number": "1841676608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5508 NIAGARA DR",
"city": "MARRERO",
"state": "LA",
"postal_code": "700724911",
"telephone_number": "504-338-4253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5508 NIAGARA DR",
"city": "MARRERO",
"state": "LA",
"postal_code": "700724911",
"telephone_number": "504-338-4253"
}
],
"practiceLocations": [
{
"address_1": "2600 Belle Chasse Hwy Ste 211",
"address_purpose": "LOCATION",
"city": "Gretna",
"state": "LA",
"postal_code": "700567156",
"country_code": "US",
"telephone_number": "504-338-4253",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCKEE",
"first_name": "DWAYNE",
"middle_name": "T",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-04",
"last_updated": "2024-11-05",
"certification_date": "2024-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "LA",
"license": "4090",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "LA",
"license": "LA4090",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMT",
"identifier": "4090",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marrero, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.