Individual provider Active NPI

Julie Anne Massengale

  • Developmental Therapist
  • Gulf Breeze, FL
National Provider Identifier
1407721715
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
5089 Mandavilla Blvd
Gulf Breeze, FL 32563-8932
Phone
(850) 407-1481
NPI assigned
Oct 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 222Q00000X FL Primary

Addresses

Primary practice location

5089 Mandavilla Blvd
Gulf Breeze, FL 32563-8932

Mailing address

5089 Mandavilla Blvd
Gulf Breeze, FL 32563-8932
Phone (850) 407-1481

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

NPI Registry JSON

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1407721715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5089 MANDAVILLA BLVD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325638932",
            "telephone_number": "850-407-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5089 MANDAVILLA BLVD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325638932",
            "telephone_number": "850-407-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENGALE",
        "first_name": "JULIE",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.