NPIMap

Organization Active NPI

Divine Health and Wellness

  • Massage Therapist
  • Lithia Springs, GA
National Provider Identifier
1891251245
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
DIVINE HEALTH AND WELLNESS
Practice address
2045 Dutchess Rd
Lithia Springs, GA 30122-2312
Phone
(770) 356-9703
NPI assigned
Feb 11, 2019
Last updated
Jun 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Authorized official

Name
Tabitha MaconNPI 1316563059
Title
Owner
Phone
(770) 356-9703

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X Primary

Addresses

Primary practice location

2045 Dutchess Rd
Lithia Springs, GA 30122-2312

Mailing address

2045 Dutchess Rd
Lithia Springs, GA 30122-2312

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1891251245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 DUTCHESS RD",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301222312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 DUTCHESS RD",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301222312",
            "telephone_number": "770-356-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-11",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "MACON",
        "authorized_official_first_name": "TABITHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-356-9703"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.