Individual provider Active NPI

Andrew Watts Williams Jr., LMT,MLD/CDP

  • Massage Therapist
  • Gulf Breeze, FL
National Provider Identifier
1013187475
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA31066 Issued in FL
Practice address
100 McAbee CT
Gulf Breeze, FL 32561-4727
Phone
(850) 982-1027
NPI assigned
Mar 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 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 MA31066 FL Primary

Addresses

Primary practice location

100 McAbee CT
Gulf Breeze, FL 32561-4727

Mailing address

100 McAbee CT
Gulf Breeze, FL 32561-4727
Phone (850) 982-1027

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
MA31066FLMDMassage 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": "1204502400000",
    "number": "1013187475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MCABEE CT",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614727",
            "telephone_number": "850-982-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MCABEE CT",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614727",
            "telephone_number": "850-982-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANDREW",
        "middle_name": "WATTS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMT,MLD/CDP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-01",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA31066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.