Individual provider Active NPI

Holly Fisher

  • Massage Therapist
  • Wellington, FL
National Provider Identifier
1639334287
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA66218 Issued in FL
Practice address
12773 W. Forest Hill Blvd.
Suite 214
Wellington, FL 33414
Phone
(561) 386-4351
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN5145078 FL
Massage Therapist 225700000X MA66218 FL Primary

Addresses

Primary practice location

12773 W. Forest Hill Blvd.
Suite 214
Wellington, FL 33414

Mailing address

1780 Harborside Cir
Wellington, FL 33414-8080
Phone (561) 386-4351

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
PN5145078FLMDLicensed Practical Nurse
MA66218FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1639334287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 HARBORSIDE CIR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148080",
            "telephone_number": "561-386-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12773 W. FOREST HILL BLVD.",
            "address_2": "SUITE 214",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "33414",
            "telephone_number": "561-386-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "HOLLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5145078",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA66218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.