Individual provider Active NPI

Ilene Fox, LMT

  • Massage Therapist
  • Blue Point, NY
National Provider Identifier
1477163822
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
18 Weeks St
Blue Point, NY 11715-1513
Phone
(631) 419-6300
NPI assigned
Jul 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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 Primary

Addresses

Primary practice location

18 Weeks St
Blue Point, NY 11715-1513

Mailing address

18 Weeks St
Blue Point, NY 11715-1513
Phone (631) 419-6300

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL serenitysource2012@gmail.com Other
Other URL serenitysource2012@gmail.com Other

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": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1477163822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 WEEKS ST",
            "city": "BLUE POINT",
            "state": "NY",
            "postal_code": "117151513",
            "telephone_number": "631-419-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 WEEKS ST",
            "city": "BLUE POINT",
            "state": "NY",
            "postal_code": "117151513",
            "telephone_number": "631-419-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "ILENE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "serenitysource2012@gmail.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Blue Point",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "18 Weeks St",
            "city": "Blue Point",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117151513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "serenitysource2012@gmail.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Blue Point",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "18 Weeks St",
            "city": "Blue Point",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117151513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Blue Point, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.