Active NPI
Nicole R Pavlus, LMT
- Massage Therapist
- Durham, NC
National Provider Identifier
1982302063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 18212
- Practice address
- 4210 N Roxboro St Ste 129
Durham, NC 27704-1874 - Phone
- (984) 377-7378
- NPI assigned
- Feb 20, 2023
- 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 | 18212 | NC | Primary |
Addresses
Primary practice location
4210 N Roxboro St Ste 129
Durham, NC 27704-1874
Mailing address
2212 Tanners Mill Dr
Durham, NC 27703-9524
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 |
|---|---|---|---|
| 18212 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676851200000",
"number": "1982302063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2212 TANNERS MILL DR",
"city": "DURHAM",
"state": "NC",
"postal_code": "277039524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4210 N ROXBORO ST STE 129",
"city": "DURHAM",
"state": "NC",
"postal_code": "277041874",
"telephone_number": "984-377-7378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVLUS",
"first_name": "NICOLE",
"middle_name": "R",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-20",
"last_updated": "2023-02-20",
"certification_date": "2023-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "18212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.