Individual provider Active NPI

Heiko Amparo Pinero Jr.

  • Massage Therapist
  • Decatur, GA
National Provider Identifier
1861123986
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT014006 Issued in GA
Practice address
1275 McConnell Dr Ste a
Decatur, GA 30033-3505
Phone
(770) 576-5906
NPI assigned
Jun 20, 2022
Last updated
Jun 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT014006 GA Primary

Addresses

Primary practice location

1275 McConnell Dr Ste a
Decatur, GA 30033-3505

Mailing address

810 Mountbury CT
Clarkston, GA 30021-2545
Phone (770) 576-5906

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

LicenseStateTypeSpecialty
MT014006GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1861123986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 MOUNTBURY CT",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300212545",
            "telephone_number": "770-576-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 MCCONNELL DR STE A",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333505",
            "telephone_number": "770-576-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINERO",
        "first_name": "HEIKO",
        "middle_name": "AMPARO",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT014006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.