Individual provider Active NPI

Sean Prescod, MA

  • Massage Therapist
  • Fort Myers, FL
National Provider Identifier
1154060424
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA89320 Issued in FL
Practice address
10720 Clear Lake Loop Apt 289
Fort Myers, FL 33908-5479
Phone
(239) 672-9452
NPI assigned
Jun 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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 MA89320 FL Primary

Addresses

Primary practice location

10720 Clear Lake Loop Apt 289
Fort Myers, FL 33908-5479

Mailing address

10720 Clear Lake Loop Apt 289
Fort Myers, FL 33908-5479
Phone (239) 672-9452

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MA89320FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1154060424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10720 CLEAR LAKE LOOP APT 289",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339085479",
            "telephone_number": "239-672-9452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10720 CLEAR LAKE LOOP APT 289",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339085479",
            "telephone_number": "239-672-9452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESCOD",
        "first_name": "SEAN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA89320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.