Susan Gibson

Primary specialty

ReflexologistTaxonomy code 173C00000X

License

MA20318 Issued in FL

Legal business name

SUSAN GIBSON

Doing business as

CST

Practice address

611 SW Federal Hwy
Stuart, FL 34994-2925

Phone

(772) 530-0093

NPI assigned

Mar 11, 2016

Last updated

Mar 11, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan Gibson, FL LMT MA20318

Title

Massage Therapist

Phone

(772) 530-0093

Specialties & licenses 1

Addresses

Other names 1

• CST Doing business as

Locations

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1750742243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5143 SE BLUE HERON LN",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349973314",
            "telephone_number": "772-530-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 SW FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942925",
            "telephone_number": "772-530-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN GIBSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MASSAGE THERAPIST",
        "authorized_official_telephone_number": "772-530-0093",
        "authorized_official_credential": "FL LMT MA20318"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "FL",
            "license": "MA20318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Reflexologist in Stuart, FL
• Providers in Stuart, FL by specialty
• Reflexologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.