Individual provider Active NPI

Nellie Aiyana Fraley, LMT

  • Massage Therapist
  • St Petersburg, FL
National Provider Identifier
1497586564
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA73690 Issued in FL
Practice address
4554 Central Ave Ste C1
St Petersburg, FL 33711-1047
Phone
(727) 469-3191
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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 MA73690 FL Primary

Addresses

Primary practice location

4554 Central Ave Ste C1
St Petersburg, FL 33711-1047

Mailing address

7210 120TH Ave
Largo, FL 33773-3213
Phone (727) 657-9064

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

LicenseStateTypeSpecialty
MA73690FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hand to Soul LLC Massage Therapist CurrentSince Oct 20, 2024 Accepting new patients

Locations

4554 Central Ave
Ste C1
St Petersburg, FL 33711
Phone (727) 469-3191

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1497586564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 120TH AVE",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337733213",
            "telephone_number": "727-657-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4554 CENTRAL AVE STE C1",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111047",
            "telephone_number": "727-469-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALEY",
        "first_name": "NELLIE",
        "middle_name": "AIYANA",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA73690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.