Active NPI
Cheryl M Thacker, LICENSED MASSAGE THE
- Massage Therapist
- Atlantic Beach, FL
National Provider Identifier
1003171588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA25185
- Practice address
- 531 Atlantic Boulevard
Ste 7
Atlantic Beach, FL 32233 - Phone
- (904) 305-4723
- NPI assigned
- Jul 10, 2012
- 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 | MA25185 | FL | Primary |
Addresses
Primary practice location
531 Atlantic Boulevard
Ste 7
Atlantic Beach, FL 32233
Mailing address
1914 Mary St.
Atlantic BCH, FL 32233-1988
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 |
|---|---|---|---|
| MA25185 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341878400000",
"number": "1003171588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1914 MARY ST.",
"city": "ATLANTIC BCH",
"state": "FL",
"postal_code": "322331988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "531 ATLANTIC BOULEVARD",
"address_2": "STE 7",
"city": "ATLANTIC BEACH",
"state": "FL",
"postal_code": "32233",
"telephone_number": "904-305-4723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THACKER",
"first_name": "CHERYL",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "LICENSED MASSAGE THE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-10",
"last_updated": "2012-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA25185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlantic Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.