Individual provider Active NPI

John Brunner

  • Massage Therapist
  • Vero Beach, FL
National Provider Identifier
1114743077
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA100406 Issued in FL
Practice address
6576 35TH PL
Vero Beach, FL 32966-7810
Phone
(765) 414-3041
NPI assigned
Nov 25, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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 MA100406 FL Primary

Addresses

Primary practice location

6576 35TH PL
Vero Beach, FL 32966-7810

Mailing address

6576 35TH PL
Vero Beach, FL 32966-7810
Phone (765) 414-3041

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
MA100406FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1114743077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6576 35TH PL",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329667810",
            "telephone_number": "765-414-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6576 35TH PL",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329667810",
            "telephone_number": "765-414-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNNER",
        "first_name": "JOHN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA100406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.