Proactive Massage & Bodywork, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

PROACTIVE MASSAGE & BODYWORK, LLC

Practice address

9291 Laurel Grove Rd
Mechanicsville, VA 23116-2969

Phone

(804) 559-7990

NPI assigned

Dec 3, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Pamela Gail Heavner, LMTNPI 1437796950

Title

Owner

Phone

(804) 559-7990

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pamela Gail Heavner, LMT

  • Massage Therapist
  • Mechanicsville, VA
  • NPI 1437796950
  NPD Authorized official

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575331200000",
    "number": "1952948481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9031 FASCINE CT",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231166570",
            "telephone_number": "804-559-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9291 LAUREL GROVE RD",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231162969",
            "telephone_number": "804-559-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MASSAGE & BODYWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-03",
        "last_updated": "2019-12-03",
        "status": "A",
        "authorized_official_last_name": "HEAVNER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "GAIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-559-7990",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019003993",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.ProactiveRVA.com",
            "affiliation": "N",
            "endpointDescription": "Website with secure user portal",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "na",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure user portal",
            "address_1": "9291 Laurel Grove Rd",
            "city": "Mechanicsville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231162969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Massage Therapist in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Massage Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.