Active NPI
Janis E. Carruth, LMT
- Specialist
- Saint Augustine, FL
National Provider Identifier
1811183353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA34916
- Practice address
- 2180 A1A S Ste 204
Saint Augustine, FL 32080-6523 - Phone
- (904) 806-2033
- NPI assigned
- Sep 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA34916 | FL | Primary |
Addresses
Primary practice location
2180 A1A S Ste 204
Saint Augustine, FL 32080-6523
Mailing address
600 Cedar Bough CT
Saint Augustine, FL 32080-6580
Phone (904) 471-7067
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA34916 | Other | FL | FLORIDA BOARD OF MASSAGE |
| C1639 | Other | FL | BLUE CROSS/BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA34916 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190160000000",
"number": "1811183353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 CEDAR BOUGH CT",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320806580",
"telephone_number": "904-471-7067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 A1A S STE 204",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320806523",
"telephone_number": "904-806-2033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRUTH",
"first_name": "JANIS",
"middle_name": "E.",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-19",
"last_updated": "2007-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "MA34916",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BOARD OF MASSAGE",
"identifier": "MA34916",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "C1639",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.