Active NPI
Melissa Dale Hall, LMT
- Massage Therapist
- St Augustine, FL
National Provider Identifier
1376668087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA22809
- Practice address
- 2155 Old Moultrie Rd
107
St Augustine, FL 32086-5102 - Phone
- (904) 501-5974
- NPI assigned
- Mar 20, 2007
- 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 | MA22809 | FL | Primary |
Addresses
Primary practice location
2155 Old Moultrie Rd
107
St Augustine, FL 32086-5102
Mailing address
2945 Kings Rd
Lot B
St Augustine, FL 32086-5467
Phone (904) 501-5974
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 |
|---|---|---|---|
| MA22809 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1376668087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2945 KINGS RD",
"address_2": "LOT B",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320865467",
"telephone_number": "904-501-5974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2155 OLD MOULTRIE RD",
"address_2": "107",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320865102",
"telephone_number": "904-501-5974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "MELISSA",
"middle_name": "DALE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA22809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.