Active NPI
Crystal Lynn Blankenship, MASSAGE THERAPIST
- Homeopath
- Avon Park, FL
National Provider Identifier
1831406644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homeopath
- License
- MA59595
- Practice address
- 1200 W Avon Blvd
Avon Park, FL 33825-8343 - Phone
- (863) 440-1535
- NPI assigned
- Sep 1, 2010
- 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 |
|---|---|---|---|---|
| Homeopath | 175L00000X | MA59595 | FL | Primary |
Addresses
Primary practice location
1200 W Avon Blvd
Avon Park, FL 33825-8343
Mailing address
3400 Garrard Rd
Fort Meade, FL 33841-9534
Phone (863) 440-1535
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA 59550 | Other | FL | MASSAGE STATE ID |
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 |
|---|---|---|---|
| MA59595 | FL | MD | Homeopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283299200000",
"number": "1831406644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 GARRARD RD",
"city": "FORT MEADE",
"state": "FL",
"postal_code": "338419534",
"telephone_number": "863-440-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W AVON BLVD",
"city": "AVON PARK",
"state": "FL",
"postal_code": "338258343",
"telephone_number": "863-440-1535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANKENSHIP",
"first_name": "CRYSTAL",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-01",
"last_updated": "2010-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "175L00000X",
"taxonomy_group": "",
"desc": "Homeopath",
"state": "FL",
"license": "MA59595",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE STATE ID",
"identifier": "MA 59550",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avon Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.