Active NPI
Ronald David Fine, C.M.T.
- Contractor
- Media, PA
National Provider Identifier
1043532112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 130 E Fifth St
Media, PA 19063-3011 - Phone
- (610) 565-3922
- NPI assigned
- Feb 17, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
130 E Fifth St
Media, PA 19063-3011
Mailing address
130 E Fifth St
Media, PA 19063-3011
Phone (610) 565-3922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016136-00 | Other | PA | NATIONAL CERTIFICATION BOARD FOR MASSAGE AND BODYWORK |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266364800000",
"number": "1043532112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 E FIFTH ST",
"city": "MEDIA",
"state": "PA",
"postal_code": "190633011",
"telephone_number": "610-565-3922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 E FIFTH ST",
"city": "MEDIA",
"state": "PA",
"postal_code": "190633011",
"telephone_number": "610-565-3922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FINE",
"first_name": "RONALD",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "C.M.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-17",
"last_updated": "2010-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL CERTIFICATION BOARD FOR MASSAGE AND BODYWORK",
"identifier": "016136-00",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.