Individual provider Active NPI

Mark Swan

  • Massage Therapist
  • Old Greenwich, CT
National Provider Identifier
1194135046
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
005132 Issued in CT
Practice address
296 Sound Beach Ave
Old Greenwich, CT 06870-1626
Phone
(203) 698-2965
NPI assigned
Apr 30, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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 005132 CT Primary

Addresses

Primary practice location

296 Sound Beach Ave
Old Greenwich, CT 06870-1626

Mailing address

296 Sound Beach Ave
Old Greenwich, CT 06870-1626
Phone (203) 698-2965

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
005132CTMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398816000000",
    "number": "1194135046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 SOUND BEACH AVE",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "068701626",
            "telephone_number": "203-698-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "296 SOUND BEACH AVE",
            "city": "OLD GREENWICH",
            "state": "CT",
            "postal_code": "068701626",
            "telephone_number": "203-698-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAN",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2014-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CT",
            "license": "005132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Greenwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.

Verify at the official NPI Registry.