Carolyn T Davis, LMT NCTMB SET

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT001114 Issued in GA

Practice address

1130 Hurricane Shoals Rd NE
Suite 1900
Lawrenceville, GA 30043-4851

Phone

(678) 462-2972

NPI assigned

Mar 5, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1972826899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 MACKENZIE CT",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192385",
            "telephone_number": "678-462-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 HURRICANE SHOALS RD NE",
            "address_2": "SUITE 1900",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434851",
            "telephone_number": "678-462-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CAROLYN",
        "middle_name": "T",
        "credential": "LMT NCTMB SET",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-05",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT001114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LICENSE",
            "identifier": "MT001114",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GWINNETT COUNTY BUSINESS LICENSE",
            "identifier": "2008002671",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFICATION OF THERAPEUTIC MASSAGE & BODYWORK",
            "identifier": "538877-07",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawntasia Daughtry
• David G Dillard, MD, LLC
• Amy Davidson, WHNP-BC
• Shana-Kae J Davis-Chance, MSN, WHNP-BC
• Beau James Davis, NP
• Ceima Davis, RN
• Emily Cheney Davis, APRN
• Holly Davis, LCSW
• India Patrina Davis
• Juanita Davis, LCSW

• Massage Therapist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Massage Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.