MR. SHUUICHI ODA (NPI# 1760752133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760752133 |
| Entity Type | Individual |
| Full Name | MR. SHUUICHI ODA |
| Credential | LMT |
| Practice Address |
1340 Gran Forest Dr Cumming GA 30041-6599 |
| Practice Telephone | 7708895406 |
| Mailing Telephone | 7708895406 |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2013-05-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MT006906 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GA STATE LICENCED MASSAGE THERAPIST | MT006906 | 01 |
| CO | ABMP INSURANCE COVERAGE | 985492 | 01 |
| Street Address |
1340 GRAN FOREST DR |
| City | CUMMING |
| State | GA |
| Zip Code | 30041-6599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962036905 | Annie Kyungjin Han | Nurse Practitioner | 1505 Northside Forsyth Drive, Suite 2500, Cumming, GA 30041 | 2020-02-28 |
| 1295388197 | Pamela Edler | Pharmacist | 1200 Northside Forsyth Drive, Pharmacy Department, Cumming, GA 30041 | 2019-07-19 |
| 1720557127 | Dr. Tiffany Lamonde LLC | Physical Therapist | 1445 Haw Creek Circle, Suite 503, Cumming, GA 30041 | 2018-11-15 |
| 1487140893 | Bhbd LLC | Chiropractor | 425 Peachtree Parkway, Suite 315, Cumming, GA 30041 | 2018-07-09 |
| 1891219861 | Anna Gawrys | Pharmacist | 1525 Marketplace Blvd, Cumming, GA 30041 | 2017-08-01 |
| 1679029219 | Square One Dental LLC | Clinic/Center | 3510 Rowe Lane, Cumming, GA 30041 | 2016-09-01 |
| 1720441454 | Pavilion Psychological Services LLC | Psychologist | 1445 Haw Creek Corners Circle East, Suite 501, Cumming, GA 30041 | 2016-03-31 |
| 1346606506 | American Health Imaging of Ga, LLC | Clinic/Center | 1050 Haw Creek Pkwy, Suite 100, Cumming, GA 30041 | 2016-01-04 |
| 1013311307 | Stephen Hartle | Physician Assistant | 2576 Peachtree Pkwy, Suite 100, Cumming, GA 30041 | 2014-10-15 |
| 1063828408 | Stephanie Evans Wellborn | Physician Assistant | 1800 Northside Forsyth Dr Ste 450, Cumming, GA 30041 | 2014-07-07 |
| Find all providers in zip 30041 | ||||
| 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 |
|---|---|---|---|---|
| 1487106092 | Alicia Hope Cooper | Massage Therapist | 107 Pilgrim Village Dr, Suite 400-g, Cumming, GA 30040-9239 | 2016-10-30 |
| 1639183999 | Tiffany Edna Croft | Massage Therapist | 309 Pirkle Ferry Rd Ste A200, Cumming, GA 30040-2546 | 2006-07-29 |
| 1306200670 | Cynthia Willard | Massage Therapist | 2450 Atlanta Hwy, 1702b, Cumming, GA 30040-8099 | 2016-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346169 | Debra Davis | Massage Therapist | 702 Baldwin Dr Ste A, Albany, GA 31707-4027 | 2020-11-06 |
| 1780285197 | Tyrone Roy | Massage Therapist | 869 King Rd, Stone Mountain, GA 30088-2203 | 2020-11-03 |
| 1295336758 | Nadia Elizabeth Jones | Massage Therapist | 300 S Hamilton St, Dalton, GA 30720-8215 | 2020-11-02 |
| 1164022968 | Gregory R Bell Jr. | Massage Therapist | 106 W Henry St # B, Savannah, GA 31401-6721 | 2020-10-30 |
| 1770183527 | Alexander Jones | Massage Therapist | 626 Dekalb Ave Se Apt 1445, Atlanta, GA 30312-5409 | 2020-10-30 |
| 1134728124 | Quaniessa Rochelle Jenkins | Massage Therapist | 449 Oak Dr # 2, Atlanta, GA 30354-1228 | 2020-10-20 |
| 1598364630 | Amy Yang | Massage Therapist | 4505 Bradstone Trce Nw, Lilburn, GA 30047-8019 | 2020-10-20 |
| 1073112405 | Tavia Rena Bell | Massage Therapist | 2512 Grayton Loop, Villa Rica, GA 30180-6702 | 2020-10-17 |
| 1063010437 | Miranda Browne | Massage Therapist | 335 Roberts Rd, Athens, GA 30606-1227 | 2020-10-16 |
| 1710585567 | Lailyn Pineda Burkett | Massage Therapist | 3550 Ga Highway 20 South, Conyers, GA 30013-2877 | 2020-10-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. SHUUICHI ODA.
| 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.