Active NPI
Poungsri Vonbernuth, LMT
- Massage Therapist
- Brandon, FL
National Provider Identifier
1295903094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA13798
- Practice address
- 110 E Windhorst Rd
Brandon, FL 33510-2524 - Phone
- (813) 685-2315
- NPI assigned
- Feb 14, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | MM11331 | FL | |
| Massage Therapist | 225700000X | MA13798 | FL | Primary |
Addresses
Primary practice location
110 E Windhorst Rd
Brandon, FL 33510-2524
Mailing address
110 E Windhorst Rd
Brandon, FL 33510-2524
Phone (813) 685-2315
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 |
|---|---|---|---|
| MA13798 | FL | MD | Massage Therapist |
| MM11331 | FL | MD | Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thai Medical Massage | Massage Therapist | 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": "1202947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202947200000",
"number": "1295903094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 E WINDHORST RD",
"city": "BRANDON",
"state": "FL",
"postal_code": "335102524",
"telephone_number": "813-685-2315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 E WINDHORST RD",
"city": "BRANDON",
"state": "FL",
"postal_code": "335102524",
"telephone_number": "813-685-2315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VONBERNUTH",
"first_name": "POUNGSRI",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-14",
"last_updated": "2008-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "FL",
"license": "MM11331",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA13798",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.