Individual provider Active NPI

Terra Kernaghan, LMT

  • Massage Therapist
  • Jacksonville, FL
National Provider Identifier
1528879608
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA103110 Issued in FL
Practice address
4540 Southside Blvd Ste 302
Jacksonville, FL 32216-5488
Phone
(904) 296-9545
NPI assigned
Jan 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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 MA103110 FL Primary

Addresses

Primary practice location

4540 Southside Blvd Ste 302
Jacksonville, FL 32216-5488

Mailing address

1303 Pullen Rd
Jacksonville, FL 32216-2529
Phone (904) 383-5823

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
MA103110FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Acupuncture & Holistic Health Center Massage Therapist CurrentSince Jan 19, 2025 Accepting new patients

Locations

4540 Southside Blvd
Ste 302
Jacksonville, FL 32216
Phone (904) 296-9545

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": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1528879608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 PULLEN RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162529",
            "telephone_number": "904-383-5823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD STE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165488",
            "telephone_number": "904-296-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNAGHAN",
        "first_name": "TERRA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA103110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.