Active NPI
Marcia Petronella Renne, LMP, MMP
- Massage Therapist
- Lanham, MD
National Provider Identifier
1033460670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- R01390
- Practice address
- 4230 Forbes Blvd
Unit a
Lanham, MD 20706-4351 - Phone
- (240) 701-7700
- NPI assigned
- Sep 22, 2012
- Last updated
- Sep 16, 2014
- 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 | R01390 | MD | Primary |
Addresses
Primary practice location
4230 Forbes Blvd
Unit a
Lanham, MD 20706-4351
Mailing address
2208 Brightseat Rd
Apt 302
Landover, MD 20785-3509
Phone (240) 701-7700
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 |
|---|---|---|---|
| R01390 | MD | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410825600000",
"number": "1033460670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2208 BRIGHTSEAT RD",
"address_2": "APT 302",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207853509",
"telephone_number": "240-701-7700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4230 FORBES BLVD",
"address_2": "UNIT A",
"city": "LANHAM",
"state": "MD",
"postal_code": "207064351",
"telephone_number": "240-701-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNE",
"first_name": "MARCIA",
"middle_name": "PETRONELLA",
"credential": "LMP, MMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-22",
"last_updated": "2014-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MD",
"license": "R01390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lanham, MD
- Fnu Relindis Makuondo Amban
- Remedy Chiropractic Care
- Steven Scott Remsen II, M.D.
- Renal Treatment Centers Mid Atlantic Inc. (Renal Care of Lanham)
- Shardai M Rene, CRNP
- Renoxx Behavioral Health Services, Inc
- Renoxx Behavioral Health Services, Inc
- Renoxx Caregivers, Inc
- Renoxx Caregivers, Inc
- Renoxx Caregivers, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.