Individual provider Active NPI

Andrew Scott Kittsley, LMT

  • Massage Therapist
  • Orlando, FL
National Provider Identifier
1083211635
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
37063 Issued in FL
Practice address
300 N Mills Ave
Orlando, FL 32803-5720
Phone
(407) 461-5090
NPI assigned
Oct 7, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 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 37063 FL Primary

Addresses

Primary practice location

300 N Mills Ave
Orlando, FL 32803-5720

Mailing address

4021 Waterfront Pkwy
Orlando, FL 32806-7462
Phone (407) 461-5090

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
37063FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1083211635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 WATERFRONT PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328067462",
            "telephone_number": "407-461-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035720",
            "telephone_number": "407-461-5090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTSLEY",
        "first_name": "ANDREW",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "37063",
            "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 Oct 7, 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.