Individual provider Active NPI

Suzette Irene Haxton

  • Massage Therapist
  • Port Charlotte, FL
National Provider Identifier
1932409471
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA25939 Issued in FL
Practice address
1032 Tamiami TRL
Unit 1
Port Charlotte, FL 33953-3802
Phone
(941) 628-8904
NPI assigned
Nov 1, 2010
Last updated
Nov 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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 MA25939 FL Primary

Addresses

Primary practice location

1032 Tamiami TRL
Unit 1
Port Charlotte, FL 33953-3802

Mailing address

1032 Tamiami TRL
Unit 1
Port Charlotte, FL 33953-3802
Phone (941) 628-8904

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
MA25939FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1932409471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 TAMIAMI TRL",
            "address_2": "UNIT 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339533802",
            "telephone_number": "941-628-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 TAMIAMI TRL",
            "address_2": "UNIT 1",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339533802",
            "telephone_number": "941-628-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAXTON",
        "first_name": "SUZETTE",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA25939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

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

Verify at the official NPI Registry.