Individual provider Active NPI

Susie J Finfrock, LMT

  • Massage Therapist
  • Gainesville, FL
National Provider Identifier
1821211459
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA18269 Issued in FL
Practice address
2411 NW 41St St
Suite D
Gainesville, FL 32606-7499
Phone
(352) 380-0300
Fax
(352) 335-3939
NPI assigned
Apr 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 MA18269 FL Primary

Addresses

Primary practice location

2411 NW 41St St
Suite D
Gainesville, FL 32606-7499

Mailing address

7732 SW 52ND PL
Gainesville, FL 32608-4471
Phone (352) 375-9955

Other identifiers 2

IdentifierTypeStateIssuer
MA182689OtherFLMASSAGE LICENSE
C7488OtherFLBC BS PROVIDER

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
MA18269FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821211459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7732 SW 52ND PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084471",
            "telephone_number": "352-375-9955",
            "fax_number": "352-335-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 NW 41ST ST",
            "address_2": "SUITE D",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326067499",
            "telephone_number": "352-380-0300",
            "fax_number": "352-335-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINFROCK",
        "first_name": "SUSIE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA18269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LICENSE",
            "identifier": "MA182689",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS PROVIDER",
            "identifier": "C7488",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, 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.