Individual provider Active NPI

Austin Jensen, PTA, LMT, CSCS

  • Massage Therapist
  • Bradenton, FL
National Provider Identifier
1700577947
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA71263 Issued in FL
Practice address
2601 Manatee Ave W
Bradenton, FL 34205-4942
Phone
(941) 779-7539
NPI assigned
May 18, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA26159 FL
Massage Therapist 225700000X MA71263 FL Primary

Addresses

Primary practice location

2601 Manatee Ave W
Bradenton, FL 34205-4942

Mailing address

11508 11TH Ave E
Bradenton, FL 34212-2501
Phone (941) 779-7539

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
PTA26159FLMDPhysical Therapy Assistant
MA71263FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1700577947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11508 11TH AVE E",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342122501",
            "telephone_number": "941-779-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342054942",
            "telephone_number": "941-779-7539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "AUSTIN",
        "name_prefix": "Mr.",
        "credential": "PTA, LMT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA26159",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA71263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.