Individual provider Active NPI

Robert Brewster III, CMT

  • Massage Therapist
  • Rohnert Park, CA
National Provider Identifier
1871313643
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
86337 Issued in CA
Practice address
8763 Laurelwood Dr
Rohnert Park, CA 94928-4627
Phone
(707) 694-9972
NPI assigned
Oct 15, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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 86337 CA Primary

Addresses

Primary practice location

8763 Laurelwood Dr
Rohnert Park, CA 94928-4627

Mailing address

8763 Laurelwood Dr
Rohnert Park, CA 94928-4627
Phone (707) 694-9972

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
86337CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1871313643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8763 LAURELWOOD DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949284627",
            "telephone_number": "707-694-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8763 LAURELWOOD DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949284627",
            "telephone_number": "707-694-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWSTER",
        "first_name": "ROBERT",
        "name_suffix": "III",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "86337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.