OCTAVIA ELAYNE MCKENNEY (NPI# 1811529225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811529225 |
| Entity Type | Individual |
| Full Name | OCTAVIA ELAYNE MCKENNEY |
| Practice Address |
3577 Main Station Dr Sw Marietta GA 30008-6054 |
| Practice Telephone | 6788691250 |
| Mailing Telephone | 6788691250 |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MT011404 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3577 MAIN STATION DR SW |
| City | MARIETTA |
| State | GA |
| Zip Code | 30008-6054 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952740276 | Beta Discount Pharmacy & Health Services, LLC | Pharmacy | 776 Sandtown Rd Sw, Marietta, GA 30008 | 2013-06-19 |
| 1982935607 | Family Home Care, LLC | Respite Care | 1791 Silver Leaf Ct, Marietta, GA 30008 | 2010-01-20 |
| 1952546533 | Daniel Park | Plastic Surgery | 2285 Asquith Ave Sw Ste 200, Marietta, GA 30008 | 2008-12-10 |
| 1265657399 | Scott D Warner | Chiropractor | 3201 Austell Rd Sw, Marietta, GA 30008 | 2007-04-16 |
| 1972572642 | Cobb County Board of Health | Public Health or Welfare | 1650 County Services Parkway, Marietta, GA 30008 | 2006-03-15 |
| 1538662622 | Lorna Brown | Nurse Practitioner | 1825 County Services Pkwy Sw, Marietta, GA 30008 | 2018-03-14 |
| 1760825905 | Avantika Varma | Family Medicine | 1650 County Services Pkwy Sw Ste 200, Marietta, GA 30008 | 2013-04-08 |
| 1689887663 | Brenda W Wilson | Psychiatry & Neurology | 1650 County Services Pkwy, Marietta, GA 30008 | 2007-05-07 |
| 1043423023 | Karen J Carter | Psychiatry & Neurology | 1650 County Services Pkwy, Marietta, GA 30008 | 2007-05-07 |
| 1043587330 | Francine Edwards | Speech-Language Pathologist | 3665 Austell Road Sw, Suite 1017, Marietta, GA 30008-0000 | 2011-11-30 |
| Find all providers in zip 30008 | ||||
| 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 |
|---|---|---|---|---|
| 1437764313 | Alan Atogamis De Souza | Massage Therapist | 2359 Windy Hill Rd Se Ste 320, Marietta, GA 30067-8660 | 2020-09-09 |
| 1578175055 | Lucretia Benee Vinson | Massage Therapist | 2575 Whitehaven Dr Sw Ste 121, Marietta, GA 30064-4569 | 2020-08-17 |
| 1740800192 | Patricia Taylor | Massage Therapist | 2123 Favor Rd Sw Apt 8, Marietta, GA 30060-4769 | 2020-04-24 |
| 1154955631 | Carlene Croney | Massage Therapist | 3002 Kingston Ct Se, Marietta, GA 30067-8957 | 2020-02-24 |
| 1861030694 | Linda Nordahl | Massage Therapist | 145 Church St Ne Ste 103, Marietta, GA 30060-1691 | 2019-12-11 |
| 1376197764 | Tracey E Moody | Massage Therapist | 1838 Blackwater Dr, Marietta, GA 30066-6712 | 2019-07-24 |
| 1558839126 | April Denise Mills | Massage Therapist | 4875 Olde Towne Pkwy Ste 50, Marietta, GA 30068-5632 | 2018-11-12 |
| 1497264527 | Lakisha Gaines | Massage Therapist | 349 Alexander Cir Se, Marietta, GA 30060-2238 | 2017-09-20 |
| 1700317724 | Bria Dailey | Massage Therapist | 4645 Kempton Pl Ne, Marietta, GA 30067-3642 | 2017-03-22 |
| 1225585342 | Hilda Colon | Massage Therapist | 41 West Market Street, Marietta, PA 17547 | 2016-09-07 |
| Find all providers in MARIETTA | ||||
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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.