Individual provider Active NPI

Thomas Hutteman, LMT

  • Massage Therapist
  • Fort Myers, FL
National Provider Identifier
1205958451
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA43520 Issued in FL
Practice address
1650 Medical LN
Fort Myers, FL 33907-1116
Phone
(239) 839-8801
NPI assigned
Apr 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 MA43520 FL Primary

Addresses

Primary practice location

1650 Medical LN
Fort Myers, FL 33907-1116

Mailing address

7164 Kola Ter Apt 32
Fort Myers, FL 33907-7712

Other identifiers 1

IdentifierTypeStateIssuer
Y902LOtherFLFL BCBS GROUP PROV. NUMBE

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
MA43520FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Rehab Services, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205958451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7164 KOLA TER APT 32",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 MEDICAL LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071116",
            "telephone_number": "239-839-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTEMAN",
        "first_name": "THOMAS",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA43520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS GROUP PROV. NUMBE",
            "identifier": "Y902L",
            "state": "FL"
        }
    ],
    "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 Jul 9, 2007; 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.