Individual provider Active NPI

Kathe Angell, LMT

  • Massage Therapist
  • Holly Hill, FL
National Provider Identifier
1649585506
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA18957 Issued in FL
Practice address
608 Marlene Dr
Holly Hill, FL 32117-3451
Phone
(386) 453-0250
NPI assigned
Aug 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 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 MA18957 FL Primary

Addresses

Primary practice location

608 Marlene Dr
Holly Hill, FL 32117-3451

Mailing address

PO Box 238347
Port Orange, FL 32123-8347
Phone (386) 453-0250

Other identifiers 1

IdentifierTypeStateIssuer
MA18957OtherFLSTATE LICENSE

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
MA18957FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1649585506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 238347",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321238347",
            "telephone_number": "386-453-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 MARLENE DR",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321173451",
            "telephone_number": "386-453-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELL",
        "first_name": "KATHE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA18957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MA18957",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Hill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.