Individual provider Active NPI

Larry Stephen Semerad, B.A., L.M.T.

  • Massage Therapist
  • Destin, FL
National Provider Identifier
1770655672
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA31435 Issued in FL
Practice address
9 Gulf Breeze CT
Destin, FL 32541-3041
Phone
(850) 830-4608
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA31435 FL Primary

Addresses

Primary practice location

9 Gulf Breeze CT
Destin, FL 32541-3041

Mailing address

66 Dalton Dr.
Santa Rosa Beach, FL 32459-6512
Phone (850) 830-4608

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
MA31435FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770655672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 DALTON DR.",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324596512",
            "telephone_number": "850-830-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 GULF BREEZE CT",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325413041",
            "telephone_number": "850-830-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMERAD",
        "first_name": "LARRY",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "B.A., L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA31435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.