Individual provider Active NPI

Calvin Ngo

  • Massage Therapist
  • Orlando, FL
National Provider Identifier
1013554096
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
91717 Issued in FL
Practice address
6900 Tavistock Lakes Blvd Ste 110
Orlando, FL 32827-7590
Phone
(407) 906-6550
NPI assigned
Dec 9, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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 91717 FL Primary

Addresses

Primary practice location

6900 Tavistock Lakes Blvd Ste 110
Orlando, FL 32827-7590

Mailing address

1146 Delphinium Dr
Orlando, FL 32825-6712
Phone (407) 929-2325

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
91717FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Owl Massage Massage Therapist CurrentSince Jan 17, 2021 Accepting new patients

Locations

6900 Tavistock Lakes Blvd
Ste 110
Orlando, FL 32827
Phone (321) 225-6505

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1013554096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 DELPHINIUM DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328256712",
            "telephone_number": "407-929-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 TAVISTOCK LAKES BLVD STE 110",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277590",
            "telephone_number": "407-906-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "CALVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "91717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.