Active NPI
Thomas Michael Rose, LMT
- Massage Therapist
- New Smyrna Beach, FL
National Provider Identifier
1063636900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA24979
- Practice address
- 417 N Causeway
New Smyrna Beach, FL 32169-5266 - Phone
- (386) 426-2232
- Fax
- (386) 426-7866
- NPI assigned
- Apr 12, 2007
- 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 | MA24979 | FL | Primary |
Addresses
Primary practice location
417 N Causeway
New Smyrna Beach, FL 32169-5266
Mailing address
308 Due East Ave
New Smyrna Beach, FL 32169-2413
Phone (386) 478-0022
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 |
|---|---|---|---|
| MA24979 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063636900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 DUE EAST AVE",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321692413",
"telephone_number": "386-478-0022",
"fax_number": "386-426-7866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 N CAUSEWAY",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321695266",
"telephone_number": "386-426-2232",
"fax_number": "386-426-7866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA24979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Smyrna Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.