Active NPI
Julie Anne Wilson
- Massage Therapist
- Rockledge, FL
National Provider Identifier
1548415466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA#52991
- Practice address
- 1982 Rockledge Blvd Ste 102
Rockledge, FL 32955-3760 - Phone
- (321) 631-5366
- NPI assigned
- Nov 19, 2008
- 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 | MA#52991 | FL | Primary |
Addresses
Primary practice location
1982 Rockledge Blvd Ste 102
Rockledge, FL 32955-3760
Mailing address
1263 Creek Side Cir
Rockledge, FL 32955-8229
Phone (321) 960-3977
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA#52991 | Other | FL | DEPARTMENT OF HEALTH - MASSAGE THERAPY LICENSURE |
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 |
|---|---|---|---|
| MA#52991 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227052800000",
"number": "1548415466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1263 CREEK SIDE CIR",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329558229",
"telephone_number": "321-960-3977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1982 ROCKLEDGE BLVD STE 102",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329553760",
"telephone_number": "321-631-5366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JULIE",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-19",
"last_updated": "2008-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA#52991",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF HEALTH - MASSAGE THERAPY LICENSURE",
"identifier": "MA#52991",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockledge, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.