Individual provider Active NPI

Christopher Charles Keglor, L.M.T.

  • Massage Therapist
  • Gainesville, FL
National Provider Identifier
1093995540
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA41025 Issued in FL
Practice address
4820 W Newberry Rd
Gainesville, FL 32607-2249
Phone
(352) 373-2116
Fax
(352) 373-1507
NPI assigned
Nov 13, 2007
Last updated
Nov 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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 MA41025 FL Primary

Addresses

Primary practice location

4820 W Newberry Rd
Gainesville, FL 32607-2249

Mailing address

10135 SE 144TH PL
Summerfield, FL 34491-3725
Phone (352) 208-0156

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
MA41025FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Request Physical Therapy Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1093995540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10135 SE 144TH PL",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344913725",
            "telephone_number": "352-208-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 W NEWBERRY RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072249",
            "telephone_number": "352-373-2116",
            "fax_number": "352-373-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEGLOR",
        "first_name": "CHRISTOPHER",
        "middle_name": "CHARLES",
        "credential": "L.M.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-13",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA41025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.

Verify at the official NPI Registry.