MONGKON SMELSER (NPI# 1376939553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376939553 |
| Entity Type | Individual |
| Full Name | MONGKON SMELSER |
| Credential | LMT |
| Practice Address |
12603 Highway 57 Vancleave MS 39565-7420 |
| Mailing Address |
Po Box 5667 Vancleave MS 39565-5667 |
| Practice Telephone | 2282835083 |
| Mailing Telephone | 2282835083 |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 823 | MS | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 172M00000X | Mechanotherapist | 823 | MS | Other Service Providers |
| Street Address |
12603 HIGHWAY 57 |
| City | VANCLEAVE |
| State | MS |
| Zip Code | 39565-7420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053707224 | Massage Connexion, LLC | Mechanotherapist | 12603 Highway 57, Vancleave, MS 39565-7420 | 2015-04-14 |
| 1013303296 | Charlene Russell | Massage Therapist | 12603 Highway 57, Vancleave, MS 39565-7420 | 2015-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548761950 | Jake Wallace Carzoli | Nurse Practitioner | 11700 Ms-57, Vancleave, MS 39565 | 2018-02-22 |
| 1992129316 | Ashlynn Evan Crum | Speech-Language Pathologist | 8728 Doobie Ct., Vancleave, MS 39565 | 2014-02-05 |
| 1851695720 | Coast Nurse Practitioners, Inc. | Nurse Practitioner | 13300 R.s. Kimball Road, Vancleave, MS 39565 | 2011-01-06 |
| 1538484761 | Sarah Burke | Speech-Language Pathologist | 477 Colonel Vickrey Road, Vancleave, MS 39565 | 2010-03-31 |
| 1194058842 | Jackson County School District | Local Education Agency (LEA) | 4700 Colonel Vickrey Road, Vancleave, MS 39565 | 2009-09-14 |
| 1962566224 | John Michael Martin | Nurse Practitioner | 1330 R S Kimball, Vancleave, MS 39565 | 2006-12-21 |
| 1619919156 | Lennon E. Bowen Iv | Psychiatry & Neurology | 6300 E Lake Blvd Ste 201, Vancleave, MS 39565 | 2006-06-11 |
| 1396233490 | Dorian R Blake | Nurse Practitioner | 6300 E Lake Blvd Ste 201, Vancleave, MS 39565 | 2018-04-25 |
| 1164971867 | Clarissa Picard | Occupational Therapist | 6300 East Lake Blvd., Suite 301, Vancleave, MS 39565 | 2016-09-23 |
| 1629427174 | Amanda Rayburn | Registered Nurse | 6300 E Lake Blvd Ste 201, Vancleave, MS 39565 | 2016-06-06 |
| Find all providers in zip 39565 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013303296 | Charlene Russell | Massage Therapist | 12603 Highway 57, Vancleave, MS 39565-7420 | 2015-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033728639 | Latoya R Thompson | Massage Therapist | 119 S Madison St, Kosciusko, MS 39090-3628 | 2020-07-29 |
| 1477174928 | Tina Whitehead | Massage Therapist | 518 Hwy 12 W, Starkville, MS 39759 | 2020-05-06 |
| 1275154338 | Crystal Edwards | Massage Therapist | 2718 Medgar Evers Blvd, Jackson, MS 39213-7257 | 2020-04-30 |
| 1265063135 | Georgene Ferrie | Massage Therapist | 1612 Main St., Fayette, MS 39069 | 2020-01-30 |
| 1578103735 | Sandra Suggs | Massage Therapist | 2621 W Oxford Loop Ste C, Oxford, MS 38655-5442 | 2020-01-15 |
| 1881236479 | Donna Summers | Massage Therapist | 761 Woodlake Dr, Jackson, MS 39206-2219 | 2019-10-15 |
| 1538715305 | Charles Louis Wilson | Massage Therapist | 2900 Government St Ste A, Ocean Springs, MS 39564-5647 | 2019-08-16 |
| 1619531084 | Derek Cumberland | Massage Therapist | 505 Oakleigh Pl, Brandon, MS 39047-6297 | 2019-04-30 |
| 1710461223 | Lamonica P Starks | Massage Therapist | 118 Weisenberger Rd Ste 200, Madison, MS 39110-5012 | 2018-09-20 |
| 1497295117 | Eletha Walker | Massage Therapist | 215 Walker Smith Rd, Florence, MS 39073 | 2017-02-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.