Active NPI
James A Vonderheide, LMT MA49956
- Massage Therapist
- Destin, FL
National Provider Identifier
1184803165
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(2) exclusion effective Oct 20, 2021.
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA49956
- Practice address
- 623 Harbor Blvd
Ste 7
Destin, FL 32541 - Phone
- (850) 424-3345
- Fax
- (850) 424-3346
- NPI assigned
- Oct 26, 2007
- Last updated
- Oct 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA49956 | FL | Primary |
Addresses
Primary practice location
623 Harbor Blvd
Ste 7
Destin, FL 32541
Mailing address
623 Harbor Blvd
Ste 7
Destin, FL 32541
Phone (850) 424-3345
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA49956 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193356800000",
"number": "1184803165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 HARBOR BLVD",
"address_2": "STE 7",
"city": "DESTIN",
"state": "FL",
"postal_code": "32541",
"telephone_number": "850-424-3345",
"fax_number": "850-424-3346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "623 HARBOR BLVD",
"address_2": "STE 7",
"city": "DESTIN",
"state": "FL",
"postal_code": "32541",
"telephone_number": "850-424-3345",
"fax_number": "850-424-3346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VONDERHEIDE",
"first_name": "JAMES",
"middle_name": "A",
"credential": "LMT MA49956",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-26",
"last_updated": "2007-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA49956",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Destin, FL
- Angel R Vasquez, DMD
- Amanda Nicholle Vaughn, COTA/L
- Erin Maige Vickers, MSN, APRN, FNP-BC
- Amanda Vicknair, APRN, NP-C
- Jessica Marie Virtue, LMT
- Wal-Mart Stores East , LP (Walmart Pharmacy 10-5924)
- Wal-Mart Stores East LP (Walmart Pharmacy 10-1362)
- Wal-Mart Stores East, LP (Vision Center 30-1362)
- Walgreen Co (Walgreens #06578)
- Walgreen Co (Walgreens #04913)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.