Active NPI
Crystal Madonna Speller, LMT
- Massage Therapist
- Ormond Beach, FL
National Provider Identifier
1902420581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA79922
- Practice address
- 1400 Hand Ave Ste T
Ormond Beach, FL 32174-8196 - Phone
- (386) 451-8196
- NPI assigned
- May 30, 2020
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA79922 | FL | Primary |
Addresses
Primary practice location
1400 Hand Ave Ste T
Ormond Beach, FL 32174-8196
Mailing address
1400 Hand Ave Ste T
Ormond Beach, FL 32174-8196
Phone (386) 451-8196
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 |
|---|---|---|---|
| MA79922 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590796800000",
"number": "1902420581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 HAND AVE STE T",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321748196",
"telephone_number": "386-451-8196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 HAND AVE STE T",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321748196",
"telephone_number": "386-451-8196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPELLER",
"first_name": "CRYSTAL",
"middle_name": "MADONNA",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-05-30",
"last_updated": "2020-05-30",
"certification_date": "2020-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA79922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
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- Specialty Surgery Partners Center of Florida, LLC (Alliance Specialty Surgical Center)
- Specialtycarerx LLC
- Hannah Speece, AUD
- Alan David Spertus, MD
- Shane Spiker, BCBA
- Spine Soldier Chiropractic Clinics
- Spoli Corp (Bethesda Manor)
- Spoli Investments Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.