Massage Therapy Services

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA-14579 Issued in FL

Legal business name

MASSAGE THERAPY SERVICES

Practice address

290 Clyde Morris Blvd
Ormond Beach, FL 32174-8130

Phone

(386) 258-7900

Fax

(386) 898-0459

NPI assigned

Dec 13, 2011

Last updated

Dec 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Joseph Fasone, LMTNPI 1134497555

Title

Owner

Phone

(386) 258-7900

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Joseph Fasone, MASSAGE THERAPIST

  • Specialist
  • Ormond Beach, FL
  • NPI 1134497555
  NPD (past) Authorized official

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323734400000",
    "number": "1386912707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 730354",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321730354",
            "telephone_number": "386-258-7900",
            "fax_number": "386-898-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 CLYDE MORRIS BLVD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748130",
            "telephone_number": "386-258-7900",
            "fax_number": "386-898-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSAGE THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-13",
        "last_updated": "2011-12-13",
        "status": "A",
        "authorized_official_last_name": "FASONE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-258-7900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA-14579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "C-5306",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.