Addison James Reiser, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2018035179 Issued in MO

Practice address

310 Route 66 E
Waynesville, MO 65583-2648

Phone

(573) 774-3833

NPI assigned

May 19, 2020

Last updated

May 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 2 For Him, LLC

  dba Serenity Spa & Wellness Center

  • Clinic/Center
  • Waynesville, MO
  • NPI 1447873914
  NPD

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1932722410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 ROUTE 66 E",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832648",
            "telephone_number": "573-774-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 ROUTE 66 E",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832648",
            "telephone_number": "573-774-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISER",
        "first_name": "ADDISON",
        "middle_name": "JAMES",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-19",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MO",
            "license": "2018035179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Waynesville, MO
• Providers in Waynesville, MO by specialty
• Massage Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.