Active NPI
Adele Marie Ngo Banack
- Massage Therapist
- Lawrenceville, GA
National Provider Identifier
1972260735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT006744
- Practice address
- 1755 N Brown Rd Ste 200
Lawrenceville, GA 30043-2018 - Phone
- (678) 851-9972
- NPI assigned
- Nov 29, 2021
- Sex
- Female
- Sole proprietor
- No
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 | MT006744 | GA | Primary |
Addresses
Primary practice location
1755 N Brown Rd Ste 200
Lawrenceville, GA 30043-2018
Mailing address
1755 N Brown Rd Ste 200
Lawrenceville, GA 30043-2018
Phone (678) 851-9972
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | adele@mybestenergyhealers.com | Direct | |
| Direct Messaging Address | Adele@mybestenergyhealers.com |
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 |
|---|---|---|---|
| MT006744 | GA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1972260735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1755 N BROWN RD STE 200",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300432018",
"telephone_number": "678-851-9972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1755 N BROWN RD STE 200",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300432018",
"telephone_number": "678-851-9972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGO BANACK",
"first_name": "ADELE",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-29",
"last_updated": "2021-11-29",
"certification_date": "2021-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "GA",
"license": "MT006744",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "adele@mybestenergyhealers.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1755 N Brown Rd Ste 200",
"city": "Lawrenceville",
"state": "GA",
"country_code": "US",
"postal_code": "300432018",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Adele@mybestenergyhealers.com",
"affiliation": "N",
"address_1": "1755 N Brown Rd Ste 200",
"city": "Lawrenceville",
"state": "GA",
"country_code": "US",
"postal_code": "300432018",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.