Individual provider Active NPI

Santa L Kennedy, MTH

  • Massage Therapist
  • N Miami Beach, FL
National Provider Identifier
1083863484
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
LMT37820 Issued in FL
Practice address
1921 NE 187TH Dr
N Miami Beach, FL 33179-4347
Phone
(305) 724-5598
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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 LMT37820 FL Primary

Addresses

Primary practice location

1921 NE 187TH Dr
N Miami Beach, FL 33179-4347

Mailing address

1921 NE 187TH Dr
N Miami Beach, FL 33179-4347
Phone (305) 724-5598

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
Credentials
Master of Theology

State licenses

LicenseStateTypeSpecialty
LMT37820FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1083863484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 NE 187TH DR",
            "city": "N MIAMI BEACH",
            "state": "FL",
            "postal_code": "331794347",
            "telephone_number": "305-724-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 NE 187TH DR",
            "city": "N MIAMI BEACH",
            "state": "FL",
            "postal_code": "331794347",
            "telephone_number": "305-724-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "SANTA",
        "middle_name": "L",
        "credential": "MTH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "LMT37820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in N Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.