Individual provider Active NPI

Michael Andrew Withers, L.M.T.

  • Massage Therapist
  • Cape Coral, FL
National Provider Identifier
1649310822
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA0016286 Issued in FL
Practice address
632 Del Prado Blvd N Ste 301
Cape Coral, FL 33909-2278
Phone
(239) 458-1222
Fax
(239) 458-1222
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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 MA0016286 FL Primary

Addresses

Primary practice location

632 Del Prado Blvd N Ste 301
Cape Coral, FL 33909-2278

Mailing address

632 Del Prado Blvd. N. Suite #301
Cape Coral, FL 33909-7207
Phone (239) 458-1222

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
MA0016286FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1649310822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 DEL PRADO BLVD. N. SUITE #301",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339097207",
            "telephone_number": "239-458-1222",
            "fax_number": "239-458-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 DEL PRADO BLVD N STE 301",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092278",
            "telephone_number": "239-458-1222",
            "fax_number": "239-458-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA0016286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.