Individual provider Active NPI

Brandi Sturdivant, LMT

  • Massage Therapist
  • Daytona Beach, FL
National Provider Identifier
1164200028
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA81240 Issued in FL
Practice address
180 Acklins Cir Apt 111
Daytona Beach, FL 32119-9786
Phone
(386) 627-5750
NPI assigned
Sep 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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 MA81240 FL Primary

Addresses

Primary practice location

180 Acklins Cir Apt 111
Daytona Beach, FL 32119-9786

Mailing address

180 Acklins Cir Apt 111
Daytona Beach, FL 32119-9786
Phone (386) 627-5750

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
MA81240FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1164200028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ACKLINS CIR APT 111",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321199786",
            "telephone_number": "386-627-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ACKLINS CIR APT 111",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321199786",
            "telephone_number": "386-627-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURDIVANT",
        "first_name": "BRANDI",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA81240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.