Individual provider Active NPI

Stefon J Collymore

  • Massage Therapist
  • White Plains, NY
National Provider Identifier
1114698651
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
028483 Issued in NY
Practice address
233A West Post Road
White Plains, NY 10606
Phone
(914) 426-9187
NPI assigned
Sep 24, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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 028483 NY Primary

Addresses

Primary practice location

233A West Post Road
White Plains, NY 10606

Mailing address

233A West Post Road
White Plains, NY 10606
Phone (914) 426-9187

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": "1632441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1114698651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233A WEST POST ROAD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "10606",
            "telephone_number": "914-426-9187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233A WEST POST ROAD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "10606",
            "telephone_number": "914-426-9187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLYMORE",
        "first_name": "STEFON",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-24",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "028483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.