Individual provider Active NPI

Bruce Allen Gonseth Sr., LMT

  • Massage Therapist
  • Ocala, FL
National Provider Identifier
1548574221
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA59342 Issued in FL
Practice address
611 NE 25TH Ave
Ocala, FL 34470-7033
Phone
(352) 362-9469
Fax
(352) 369-1122
NPI assigned
Aug 4, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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 MA59342 FL Primary

Addresses

Primary practice location

611 NE 25TH Ave
Ocala, FL 34470-7033

Mailing address

23222 NE 159TH Ave
Fort MC Coy, FL 32134-8359
Phone (352) 546-5659

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
MA59342FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1548574221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23222 NE 159TH AVE",
            "city": "FORT MC COY",
            "state": "FL",
            "postal_code": "321348359",
            "telephone_number": "352-546-5659",
            "fax_number": "352-369-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 NE 25TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344707033",
            "telephone_number": "352-362-9469",
            "fax_number": "352-369-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONSETH",
        "first_name": "BRUCE",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-04",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA59342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.