Matthew J Michaud, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA23394 Issued in FL

Practice address

3864 San Jose Park Drive
Jacksonville, FL 32217

Phone

(904) 737-8552

Fax

(904) 737-8113

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Matt Michaud Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Boben, LLC

  • Massage Therapist
  • Jacksonville, FL
  • NPI 1871815951
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245327287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3864 SAN JOSE PARK DRIVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32217",
            "telephone_number": "904-737-8552",
            "fax_number": "904-737-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3864 SAN JOSE PARK DRIVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32217",
            "telephone_number": "904-737-8552",
            "fax_number": "904-737-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAUD",
        "first_name": "MATTHEW",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA23394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMT",
            "identifier": "MA23394",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MATT",
            "last_name": "MICHAUD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Irene Fathy Michail, M.P.T.
• William David Michal, APRN
• Connor David Michalski, MD
• Kelly Elizabeth Michalski
• Amanda L Michaud, PA
• Ernst Berthony Michel, MD
• Karen J Michel
• Neemy Michel
• Michelle Barker Counseling & Consulting Services, LLC
• Michelle Goodman

• Massage Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.