Georgetown Professional Massage and Wellness LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

GEORGETOWN PROFESSIONAL MASSAGE AND WELLNESS LLC

Practice address

4887-1 Williams Drive
Suite 107
Georgetown, TX 78633

Phone

(512) 639-2769

NPI assigned

Nov 4, 2022

Last updated

Oct 31, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Deziree Simms, LMTNPI 1285341602

Title

Owner/LMT

Phone

(512) 639-2769

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deziree Simms, LMT

  • Massage Therapist
  • Georgetown, TX
  • NPI 1285341602
  NPD Authorized official

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1851008114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4887-1 WILLIAMS DRIVE",
            "address_2": "SUITE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78633",
            "telephone_number": "512-639-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4887-1 WILLIAMS DRIVE",
            "address_2": "SUITE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78633",
            "telephone_number": "512-639-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN PROFESSIONAL MASSAGE AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-04",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "SIMMS",
        "authorized_official_first_name": "DEZIREE",
        "authorized_official_title_or_position": "OWNER/LMT",
        "authorized_official_telephone_number": "512-639-2769",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Massage Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.

Verify at the official NPI Registry.