Individual provider Active NPI

Candida Jill Pratt, L.M.T

  • Massage Therapist
  • Panama City Beach, FL
National Provider Identifier
1295043248
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA42093 Issued in FL
Practice address
10200 Clarence St.
Suite B
Panama City Beach, FL 32407
Phone
(850) 235-9855
NPI assigned
Sep 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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 MA42093 FL Primary

Addresses

Primary practice location

10200 Clarence St.
Suite B
Panama City Beach, FL 32407

Mailing address

10200 Clarence St.
Suite B
Panama City Beach, FL 32407
Phone (850) 235-9855

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
MA42093FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1295043248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 CLARENCE ST.",
            "address_2": "SUITE B",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "32407",
            "telephone_number": "850-235-9855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 CLARENCE ST.",
            "address_2": "SUITE B",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "32407",
            "telephone_number": "850-235-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "CANDIDA",
        "middle_name": "JILL",
        "name_prefix": "Ms.",
        "credential": "L.M.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-23",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA42093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.