Atesha Clark, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA-60592 Issued in FL

Practice address

119 S Clyde Ave
Kissimmee, FL 34741-5613

Phone

(407) 952-6367

NPI assigned

Jun 24, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• The Healing Begins LLC

  • Massage Therapist
  • Kissimmee, FL
  • NPI 1497324248
  NPD Authorized official

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1083283824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S CLYDE AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415613",
            "telephone_number": "407-952-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 S CLYDE AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415613",
            "telephone_number": "407-952-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ATESHA",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA-60592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cja Support Care Services, LLC
• Cja Support Care Services, LLC
• Cja Therapy & Beyond LLC
• Cjam Healthcare Services
• Clarissa L Morales DMD PA
• Monica Anne Clark, APRN
• Ava Jade Claudio
• Diego G Clavell Rivera
• Dawn Clayton-Miller, PTA
• Clearview Health Solutions, Inc. (Telsa MRI)

• Massage Therapist in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.