Individual provider Active NPI

Timothy Layne Boas, L.M.T

  • Massage Therapist
  • Groveland, FL
National Provider Identifier
1013187467
Registry record updated Mar 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
46690 Issued in FL
Practice address
18404 State Road 19
Groveland, FL 34736-9542
Phone
(352) 217-8550
NPI assigned
Mar 1, 2008
Last updated
Mar 1, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 46690 FL Primary

Addresses

Primary practice location

18404 State Road 19
Groveland, FL 34736-9542

Mailing address

18404 State Road 19
Groveland, FL 34736-9542
Phone (352) 217-8550

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

LicenseStateTypeSpecialty
46690FLMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204329600000",
    "number": "1013187467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18404 STATE ROAD 19",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347369542",
            "telephone_number": "352-217-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18404 STATE ROAD 19",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347369542",
            "telephone_number": "352-217-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAS",
        "first_name": "TIMOTHY",
        "middle_name": "LAYNE",
        "credential": "L.M.T",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-01",
        "last_updated": "2008-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "46690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groveland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.