Cheryl Elizabeth Wall, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA35162 Issued in FL

Practice address

4211 U.S. Highway 1 South
Saint Augustine, FL 32086-7096

Phone

(904) 794-0854

NPI assigned

Nov 29, 2007

Last updated

Mar 31, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Cheryl Elizabeth Hanley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1679755953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 U.S. HIGHWAY 1 SOUTH",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320867096",
            "telephone_number": "904-794-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 U.S. HIGHWAY 1 SOUTH",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320867096",
            "telephone_number": "904-794-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "CHERYL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA35162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "C1650",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "HANLEY",
            "middle_name": "ELIZABETH",
            "prefix": "MRS.",
            "credential": "LMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walgreen Co. (Walgreens #11165)
• Bethany Lyn Walker, MS, CCC-SLP
• Lauren Ann Walker, PT, DPT, OTR/L, MOT
• Megan M Walker, PA-C
• Nicholas Walker, PT, DPT, CSCS
• Sabrina Wall, D.D.S.
• Karen Wallace
• Heather Waller
• Allison Lenore Walsh, BA
• Kathryn Elise Walton

• Massage Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.