Active NPI
Alfred Edward Smith Jr., CMT
- Massage Therapist
- Virginia Beach, VA
National Provider Identifier
1205246964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 0019012425
- Practice address
- 1645 Laskin Rd
Suite 104
Virginia Beach, VA 23451-6199 - Phone
- (757) 240-6049
- NPI assigned
- May 4, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 0019012425 | VA | Primary |
Addresses
Primary practice location
1645 Laskin Rd
Suite 104
Virginia Beach, VA 23451-6199
Mailing address
1645 Laskin Rd
Suite 104
Virginia Beach, VA 23451-6199
Phone (757) 240-6049
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0019012425 | VA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469232000000",
"number": "1205246964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1645 LASKIN RD",
"address_2": "SUITE 104",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234516199",
"telephone_number": "757-240-6049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1645 LASKIN RD",
"address_2": "SUITE 104",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234516199",
"telephone_number": "757-240-6049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ALFRED",
"middle_name": "EDWARD",
"name_suffix": "Jr.",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-04",
"last_updated": "2016-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "VA",
"license": "0019012425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.