Individual provider Active NPI

Rodney Harold Durost Jr., L.M.T.

  • Massage Therapist
  • Pensacola, FL
National Provider Identifier
1568714293
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA38623 Issued in FL
Practice address
5027 Antoine PL
Pensacola, FL 32505-3469
Phone
(850) 217-9336
NPI assigned
Oct 4, 2012
Last updated
Dec 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 2456 AL
Massage Therapist 225700000X MA38623 FL Primary

Addresses

Primary practice location

5027 Antoine PL
Pensacola, FL 32505-3469

Mailing address

5027 Antoine PL
Pensacola, FL 32505-3469
Phone (850) 217-9336

Other identifiers 1

IdentifierTypeStateIssuer
C2627OtherFLBLUECROSS BLUESHIELD

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
2456ALMDMassage Therapist
MA38623FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1568714293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5027 ANTOINE PL",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325053469",
            "telephone_number": "850-217-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5027 ANTOINE PL",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325053469",
            "telephone_number": "850-217-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUROST",
        "first_name": "RODNEY",
        "middle_name": "HAROLD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-04",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AL",
            "license": "2456",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA38623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "C2627",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.