Active NPI
Caegan Quimby, LMT
- Massage Therapist
- Bradenton Beach, FL
National Provider Identifier
1013739457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 79285
- Practice address
- 112 Bridge Walk
Bradenton Beach, FL 34217 - Phone
- (941) 779-6836
- NPI assigned
- Oct 28, 2024
- Last updated
- Oct 28, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 | 79285 | FL | Primary |
Addresses
Primary practice location
112 Bridge Walk
Bradenton Beach, FL 34217
Mailing address
114 Ninth St N
Bradenton Beach, FL 34217
Phone (845) 594-7836
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 |
|---|---|---|---|
| 79285 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1013739457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 NINTH ST N",
"city": "BRADENTON BEACH",
"state": "FL",
"postal_code": "34217",
"telephone_number": "845-594-7836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 BRIDGE WALK",
"city": "BRADENTON BEACH",
"state": "FL",
"postal_code": "34217",
"telephone_number": "941-779-6836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUIMBY",
"first_name": "CAEGAN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-28",
"last_updated": "2024-10-28",
"certification_date": "2024-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "79285",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradenton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.