Individual provider Active NPI

Amanda Dell Blanken, L.M.T

  • Massage Therapist
  • Palm City, FL
National Provider Identifier
1306288345
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA#27795 Issued in FL
Practice address
2796 SW Mapp Rd
Palm City, FL 34990-2720
Phone
(772) 781-9744
Fax
(772) 781-8381
NPI assigned
Jul 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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 MA#27795 FL Primary

Addresses

Primary practice location

2796 SW Mapp Rd
Palm City, FL 34990-2720

Mailing address

2796 SW Mapp Rd
Palm City, FL 34990-2720
Phone (772) 781-9744

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
MA#27795FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1306288345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2796 SW MAPP RD",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902720",
            "telephone_number": "772-781-9744",
            "fax_number": "772-781-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2796 SW MAPP RD",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902720",
            "telephone_number": "772-781-9744",
            "fax_number": "772-781-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKEN",
        "first_name": "AMANDA",
        "middle_name": "DELL",
        "credential": "L.M.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA#27795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.