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Jerrell S Bostick , BS

Massage Therapist β€’ Daytona Beach, FL

Active NPI 1003163858 Individual Practitioner Male Practitioner
Practice location in NPPES

504 Railway St
Daytona Beach, FL 321142654

Call 3866798532 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

504 Railway St

Daytona Beach, FL 321142654

Telephone 3866798532

NPI first issued

2012

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians, CMS release of October 2, 2026; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians, CMS release of October 2, 2026.

Guide: How Medicare covers telehealth

Compared with the same specialty in Daytona Beach and Florida

20 active clinicians are listed under Massage Therapist with a practice address in Daytona Beach, FL (7,086 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Daytona Beach

0% of these 20 clinicians have the CMS telehealth indicator.

0% of these 20 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-01-13
Massage Therapist Primary Specialty

NUCC Taxonomy Code: 225700000X

License # reported to NPPES TX MT135450

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Case Manager/Care Coordinator

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Massage Therapist

NUCC Taxonomy Code: 225700000X

License # reported to NPPES FL MA79474

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

12 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 13, 2024

Case Manager/Care Coordinator

βœ…
NPI Profile Active January 23, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location January 23, 2017

Registered at 504 RAILWAY ST, DAYTONA BEACH, FL 321142654 (Tel: 3866798532)

πŸ“
Updated Business Mailing Address January 23, 2017

Registered at 504 RAILWAY ST, DAYTONA BEACH, FL 321142654 (Tel: 3866798532)

πŸ‘€
Provider Name / Credentials Updated January 23, 2017

Recorded as JERRELL BOSTICK, B.S.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 23, 2017

Massage Therapist (license number reported to NPPES: FL MA79474)

βœ…
NPI Profile Active August 11, 2012

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 11, 2012

Registered at 160 N BEACH ST, DAYTONA BEACH, FL 321143314 (Tel: 3869444707)

πŸ“
Business Mailing Address (Initial Record) August 11, 2012

Registered at 160 N BEACH ST, DAYTONA BEACH, FL 321143314 (Tel: 3869444707)

πŸ‘€
Provider Name / Credentials (Initial Record) August 11, 2012

Recorded as JERRELL BOSTICK, B.S.

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 11, 2012

Case Manager/Care Coordinator

🟒
Initial NPI Registration & Enumeration August 11, 2012

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1003163858
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 11, 2012
Last Update: January 13, 2024
Sole Proprietor: Yes

Mailing Address

504 Railway St

Daytona Beach, FL 321142654

Phone: 3866798532

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.