Courtney Eliott, MA42392

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

42392 Issued in FL

Practice address

1790 A1A Hwy Ste 206
Satellite Beach, FL 32937-5440

Phone

(863) 398-2470

NPI assigned

Mar 31, 2020

Last updated

Mar 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1528696903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 E ARLINGTON ST",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329372246",
            "telephone_number": "863-398-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 A1A HWY STE 206",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329375440",
            "telephone_number": "863-398-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIOTT",
        "first_name": "COURTNEY",
        "credential": "MA42392",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "42392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPIST",
            "identifier": "42392",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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