John R. Ellis Massage, Inc.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA40808 Issued in FL

Legal business name

JOHN R. ELLIS MASSAGE, INC.

Practice address

12621 New Brittany Blvd
Suite 17W
Fort Myers, FL 33907-3631

Phone

(239) 872-4641

NPI assigned

Oct 23, 2008

Organization subpart

No

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

Authorized official

Name

John R. Ellis, LMT

Title

Owner/President

Phone

(239) 872-4641

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1740433606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 BRANTLEY RD",
            "address_2": "#801",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073994",
            "telephone_number": "239-872-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12621 NEW BRITTANY BLVD",
            "address_2": "SUITE 17W",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073631",
            "telephone_number": "239-872-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R. ELLIS MASSAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "239-872-4641",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA40808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.