Individual provider Active NPI

Marcella Ann Meister, MT

  • Massage Therapist
  • Lakewood, OH
National Provider Identifier
1164645693
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
12083 Issued in OH
Practice address
15711 Madison Ave
Lakewood, OH 44107-5655
Phone
(216) 221-5739
Fax
(216) 221-5887
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 12083 OH Primary

Addresses

Primary practice location

15711 Madison Ave
Lakewood, OH 44107-5655

Mailing address

15711 Madison Ave
Lakewood, OH 44107-5655
Phone (216) 221-5739

Other identifiers 1

IdentifierTypeStateIssuer
12083OtherOHLICENSE NUMBER

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
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
12083OHMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164645693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15711 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075655",
            "telephone_number": "216-221-5739",
            "fax_number": "216-221-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15711 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075655",
            "telephone_number": "216-221-5739",
            "fax_number": "216-221-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEISTER",
        "first_name": "MARCELLA",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "12083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "12083",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.