Active NPI
Sue Ellen Williams, LMT
- Massage Therapist
- Titusville, FL
National Provider Identifier
1508059551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA46181
- Practice address
- 772 Country Club Dr
Titusville, FL 32780-4955 - Phone
- (321) 267-2233
- NPI assigned
- Aug 23, 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 | MA46181 | FL | Primary |
Addresses
Primary practice location
772 Country Club Dr
Titusville, FL 32780-4955
Mailing address
5305 Watermill LN
Apt 204
Titusville, FL 32780-7808
Phone (321) 720-7765
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 |
|---|---|---|---|
| MA46181 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249516800000",
"number": "1508059551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5305 WATERMILL LN",
"address_2": "APT 204",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327807808",
"telephone_number": "321-720-7765",
"fax_number": "321-567-4279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "772 COUNTRY CLUB DR",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327804955",
"telephone_number": "321-267-2233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "SUE",
"middle_name": "ELLEN",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-23",
"last_updated": "2009-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA46181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Titusville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.