Individual provider Active NPI

Bannaporn Barham

  • Massage Therapist
  • Niceville, FL
National Provider Identifier
1184553588
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA75344 Issued in FL
Practice address
2198 Chase Dr
Niceville, FL 32578-1606
Phone
(850) 333-8901
NPI assigned
May 14, 2026
Last updated
May 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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 MA75344 FL Primary

Addresses

Primary practice location

2198 Chase Dr
Niceville, FL 32578-1606

Mailing address

2198 Chase Dr
Niceville, FL 32578-1606
Phone (850) 333-8901

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
MA75344FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1778716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1184553588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2198 CHASE DR",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781606",
            "telephone_number": "850-333-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2198 CHASE DR",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781606",
            "telephone_number": "850-333-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARHAM",
        "first_name": "BANNAPORN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-14",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA75344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.