Myofascial Release and Women'S Health LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

MYOFASCIAL RELEASE AND WOMEN'S HEALTH LLC

Practice address

1527 Dale Mabry Hwy Ste 105
Lutz, FL 33548-3031

Phone

(813) 482-5765

NPI assigned

May 30, 2024

Organization subpart

No

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

Authorized official

Name

Kathleen J Hennessy, DPTNPI 1285884551

Title

MGR

Phone

(813) 482-5765

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Holistic Health Practitioners Doing business as
• Myofascial Release and Women's Health LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathleen Jane Hennessy, DPT

  • Physical Therapist
  • Land O Lakes, FL
  • NPI 1285884551
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1669212239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21514 CORMORANT COVE DR",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346377523",
            "telephone_number": "813-482-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 DALE MABRY HWY STE 105",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335483031",
            "telephone_number": "813-482-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYOFASCIAL RELEASE AND WOMEN'S HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "HENNESSY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "813-482-5765",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063681526",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holistic Health Practitioners",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Myofascial Release and Women's Health LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Lutz, FL
• Providers in Lutz, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.