Individual provider Active NPI

Kerriann Samuels-Martin

  • Massage Therapist
  • Alpharetta, GA
National Provider Identifier
1902619026
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT015205 Issued in GA
Practice address
42204 Mill Creek Ave
Alpharetta, GA 30022-1100
Phone
(954) 708-7387
NPI assigned
Jan 31, 2025
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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 MT015205 GA Primary

Addresses

Primary practice location

42204 Mill Creek Ave
Alpharetta, GA 30022-1100

Mailing address

42204 Mill Creek Ave
Alpharetta, GA 30022-1100
Phone (954) 708-7387

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
MT015205GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1738281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1902619026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42204 MILL CREEK AVE",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221100",
            "telephone_number": "954-708-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42204 MILL CREEK AVE",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300221100",
            "telephone_number": "954-708-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS-MARTIN",
        "first_name": "KERRIANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-31",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT015205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.