Individual provider Active NPI

Michael J Roselip, LMT

  • Massage Therapist
  • Satellite Beach, FL
National Provider Identifier
1922366277
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA 68104 Issued in FL
Practice address
106 Sunrise Ave
Suite B
Satellite Beach, FL 32937-2510
Phone
(321) 506-7679
NPI assigned
Apr 24, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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 MA 68104 FL Primary

Addresses

Primary practice location

106 Sunrise Ave
Suite B
Satellite Beach, FL 32937-2510

Mailing address

106 Sunrise Ave
Suite B
Satellite Beach, FL 32937-2510
Phone (321) 506-7679

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
MA 68104FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1922366277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 SUNRISE AVE",
            "address_2": "SUITE B",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329372510",
            "telephone_number": "321-506-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SUNRISE AVE",
            "address_2": "SUITE B",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329372510",
            "telephone_number": "321-506-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSELIP",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA 68104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Satellite Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.