NPIMap

Organization Active NPI

Thai Medical Massage

  • Clinic/Center
  • Brandon, FL
National Provider Identifier
1922279041
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MM11331 Issued in FL
Legal business name
THAI MEDICAL MASSAGE
Practice address
110 E Windhorst Rd
Brandon, FL 33510-2524
Phone
(813) 685-2315
Fax
(813) 685-2399
NPI assigned
Mar 17, 2008
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Poungsri Vonbernuth, LMTNPI 1295903094
Title
Owner / Therapist
Phone
(813) 685-2315

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MM11331 FL Primary
Massage Therapist 225700000X MA13798 FL

Addresses

Primary practice location

110 E Windhorst Rd
Brandon, FL 33510-2524

Mailing address

110 E Windhorst Rd
Brandon, FL 33510-2524

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1922279041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E WINDHORST RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335102524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E WINDHORST RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335102524",
            "telephone_number": "813-685-2315",
            "fax_number": "813-685-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THAI MEDICAL MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "VONBERNUTH",
        "authorized_official_first_name": "POUNGSRI",
        "authorized_official_title_or_position": "OWNER / THERAPIST",
        "authorized_official_telephone_number": "813-685-2315",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "MM11331",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA13798",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.