Active NPI
Rod Bowen, LMT
- Massage Therapist
- Palatka, FL
National Provider Identifier
1104146885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA57076
- Practice address
- 2312 Crill Ave Ste 1B
Palatka, FL 32177-4828 - Phone
- (386) 385-3046
- NPI assigned
- Jun 4, 2010
- Sex
- Male
- Sole proprietor
- Yes
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA57076 | FL | MD | Massage Therapist |
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA57076 | FL | Primary |
Addresses
Primary practice location
2312 Crill Ave Ste 1B
Palatka, FL 32177-4828
Mailing address
2312 Crill Ave Ste 1B
Palatka, FL 32177-4828
Phone (386) 385-3046
NPI Registry JSON
{
"created_epoch": "1275609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275609600000",
"number": "1104146885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2312 CRILL AVE STE 1B",
"city": "PALATKA",
"state": "FL",
"postal_code": "321774828",
"telephone_number": "386-385-3046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2312 CRILL AVE STE 1B",
"city": "PALATKA",
"state": "FL",
"postal_code": "321774828",
"telephone_number": "386-385-3046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWEN",
"first_name": "ROD",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-04",
"last_updated": "2010-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA57076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palatka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.