Active NPI
Nathan Reynolds, LMT
- Massage Therapist
- Fort Mill, SC
National Provider Identifier
1972148088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 11748
- Practice address
- 3071 Highway 21 Ste 105
Fort Mill, SC 29715-7206 - Phone
- (803) 547-6634
- NPI assigned
- Nov 12, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 11748 | SC | Primary |
Addresses
Primary practice location
3071 Highway 21 Ste 105
Fort Mill, SC 29715-7206
Mailing address
3071 Highway 21 Ste 105
Fort Mill, SC 29715-7206
Phone (803) 547-6634
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 |
|---|---|---|---|
| 11748 | SC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573516800000",
"number": "1972148088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3071 HIGHWAY 21 STE 105",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297157206",
"telephone_number": "803-547-6634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3071 HIGHWAY 21 STE 105",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297157206",
"telephone_number": "803-547-6634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "NATHAN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-11-12",
"last_updated": "2019-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "SC",
"license": "11748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Mill, SC
- Revival Counseling of the Carolinas
- Revive Chiropractic PC
- Revive Neurorecovery Center CLT LLC
- Ashley Reyes, RBT
- Natalie Reynolds, RBT
- Norka Reynolds
- Kendrah Rhoden, RBT
- Riccobene & Associates CCC, DDS, PC (Riccobene & Associates Family Dentistry - Fort Mill)
- Ethan Christian Richard, D.O
- Kelly L Richard, LCSW, LISW-CP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.