Experience Anew, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

EXPERIENCE ANEW, LLC

Practice address

1720 W Fairfield Dr Ste 309
Pensacola, FL 32501-1057

Phone

(850) 207-7599

NPI assigned

Mar 15, 2021

Organization subpart

No

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

Authorized official

Name

Telecia Walker, LMT

Title

Owner/Therapist

Phone

(850) 207-7599

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Telecia Sunshine, LMT, CPC, MMP

  • Massage Therapist
  • Pensacola, FL
  • NPI 1700374618
  NPD

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1356926968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 W FAIRFIELD DR STE 309",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011057",
            "telephone_number": "850-207-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 W FAIRFIELD DR STE 309",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011057",
            "telephone_number": "850-207-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPERIENCE ANEW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "TELECIA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "850-207-7599",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105554700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pensacola",
            "affiliation": "N",
            "address_1": "1720 W Fairfield Dr Ste 309",
            "city": "Pensacola",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325011057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.