Active NPI
Autumn Vernon, LMT
- Massage Therapist
- Santa Monica, CA
National Provider Identifier
1295574846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 60894
- Practice address
- 101 Wilshire Blvd
Santa Monica, CA 90401-1106 - Phone
- (310) 319-3193
- NPI assigned
- May 23, 2024
- Sex
- Female
- 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 | 60894 | CA | Primary |
Addresses
Primary practice location
101 Wilshire Blvd
Santa Monica, CA 90401-1106
Mailing address
PO Box 1873
Santa Monica, CA 90406-1873
Phone (818) 398-2319
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 |
|---|---|---|---|
| 60894 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1295574846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1873",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904061873",
"telephone_number": "818-398-2319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WILSHIRE BLVD",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904011106",
"telephone_number": "310-319-3193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERNON",
"first_name": "AUTUMN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-23",
"last_updated": "2024-05-23",
"certification_date": "2024-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "60894",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.