Amy R Stroup, LPN, LMT, FACIALIST

Primary specialty

Other TechnicianTaxonomy code 247200000X

License

MA29603 Issued in FL

Practice address

5460 N State Road 7 Ste 217
Fort Lauderdale, FL 33319-2969

Phone

(954) 895-2697

NPI assigned

Mar 15, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Amy R Marriage Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1508131178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9124 NW 35TH PL",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333516400",
            "telephone_number": "954-895-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 N STATE ROAD 7 STE 217",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333192969",
            "telephone_number": "954-895-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROUP",
        "first_name": "AMY",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LPN, LMT, FACIALIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN0547061",
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "FL",
            "license": "MA29603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "MARRIAGE",
            "middle_name": "R",
            "prefix": "MRS.",
            "credential": "LPN, LMT, FACIALIST",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• James Stuckey
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• Other Technician in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Other Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.