NPIMap

Organization Active NPI

Spa Northwest LLC

  • Massage Therapist
  • Bradenton, FL
National Provider Identifier
1093593782
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
SPA NORTHWEST LLC
Practice address
5701 21St Ave W
Bradenton, FL 34209-5605
Phone
(941) 713-1637
NPI assigned
Sep 15, 2023
Last updated
Sep 15, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Authorized official

Name
Kelly Marie Skinner, LMTNPI 1720866411
Title
Owner
Phone
(941) 577-6560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

5701 21St Ave W
Bradenton, FL 34209-5605

Mailing address

5701 21St Ave W
Bradenton, FL 34209-5605
Phone (941) 713-1637

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1093593782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 21ST AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095605",
            "telephone_number": "941-713-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 21ST AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095605",
            "telephone_number": "941-713-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPA NORTHWEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-13",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-577-6560",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.