Individual provider Active NPI

Robert Brown, LMT

  • Massage Therapist
  • Sterling, VA
National Provider Identifier
1083339865
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0019011185 Issued in VA
Practice address
21351 Gentry Dr Ste 114
Sterling, VA 20166-8510
Phone
(703) 982-0006
NPI assigned
Oct 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225700000X 0019011185 VA Primary

Addresses

Primary practice location

21351 Gentry Dr Ste 114
Sterling, VA 20166-8510

Mailing address

21351 Gentry Dr Ste 114
Sterling, VA 20166-8510
Phone (703) 982-0006

Other identifiers 1

IdentifierTypeStateIssuer
0019011185OtherVAVIRGINIA NURSING BOARD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@sportsmassagepros.com Health Information Exchange (HIE)

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
0019011185VAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1083339865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21351 GENTRY DR STE 114",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201668510",
            "telephone_number": "703-982-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21351 GENTRY DR STE 114",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201668510",
            "telephone_number": "703-982-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ROBERT",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019011185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA NURSING BOARD",
            "identifier": "0019011185",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@sportsmassagepros.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21351 Gentry Dr Ste 114",
            "city": "Sterling",
            "state": "VA",
            "country_code": "US",
            "postal_code": "201668510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.