Individual provider Active NPI

Brittnay Konkle, LMT

  • Massage Therapist
  • Ronkonkoma, NY
National Provider Identifier
1740039346
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
033536 Issued in NY
Practice address
4155 Veterans Hwy Ste 5
Ronkonkoma, NY 11779-6063
Phone
(631) 412-4800
Fax
(631) 939-2405
NPI assigned
May 15, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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 033536 NY Primary

Addresses

Primary practice location

4155 Veterans Hwy Ste 5
Ronkonkoma, NY 11779-6063

Mailing address

42 Adams St E
East Islip, NY 11730-1602
Phone (631) 487-1185

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
033536NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Massage Fitness Works and More Massage Therapist CurrentSince May 19, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1740039346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 ADAMS ST E",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117301602",
            "telephone_number": "631-487-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 VETERANS HWY STE 5",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117796063",
            "telephone_number": "631-412-4800",
            "fax_number": "631-939-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONKLE",
        "first_name": "BRITTNAY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "033536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.