Active NPI
Destiny Guadalupe Leon
- Massage Therapist
- Midway Park, NC
National Provider Identifier
1922895861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 22572
- Practice address
- 106 Littleton St
Midway Park, NC 28544-1712 - Phone
- (279) 210-2695
- NPI assigned
- Apr 23, 2025
- Last updated
- Apr 23, 2025
- Sex
- Female
- 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 | 84112 | CA | |
| Massage Therapist | 225700000X | 22572 | NC | Primary |
Addresses
Primary practice location
106 Littleton St
Midway Park, NC 28544-1712
Mailing address
106 Littleton St
Midway Park, NC 28544-1712
Phone (279) 210-2695
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 |
|---|---|---|---|
| 84112 | CA | MD | Massage Therapist |
| 22572 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745366400000",
"number": "1922895861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 LITTLETON ST",
"city": "MIDWAY PARK",
"state": "NC",
"postal_code": "285441712",
"telephone_number": "279-210-2695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 LITTLETON ST",
"city": "MIDWAY PARK",
"state": "NC",
"postal_code": "285441712",
"telephone_number": "279-210-2695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEON",
"first_name": "DESTINY",
"middle_name": "GUADALUPE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-04-23",
"last_updated": "2025-04-23",
"certification_date": "2025-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "84112",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "22572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midway Park, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.