Individual provider Active NPI

Eric Robert Smith, LMBT

  • Massage Therapist
  • Navarre, FL
National Provider Identifier
1124534391
Registry record updated Dec 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
72094 Issued in FL
Practice address
1752 Sea Lark LN
Navarre, FL 32566-7406
Phone
(850) 542-9594
NPI assigned
Dec 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2017

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 72094 FL Primary

Addresses

Primary practice location

1752 Sea Lark LN
Navarre, FL 32566-7406

Mailing address

6633 Hartland St
Navarre, FL 32566-8103
Phone (850) 542-9594

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
72094FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1513900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513900800000",
    "number": "1124534391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6633 HARTLAND ST",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325668103",
            "telephone_number": "850-542-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 SEA LARK LN",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325667406",
            "telephone_number": "850-542-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ERIC",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LMBT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-22",
        "last_updated": "2017-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "72094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Navarre, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; 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.