Active NPI
Charles Ferguson, CMT
- Massage Therapist
- Philadelphia, PA
National Provider Identifier
1285774364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 28469
- Practice address
- 6813 Germantown Ave
Philadelphia, PA 19119-2112 - Phone
- (215) 991-6151
- NPI assigned
- Feb 7, 2007
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 28469 | PA | Primary |
Addresses
Primary practice location
6813 Germantown Ave
Philadelphia, PA 19119-2112
Mailing address
1408 Stotesbury Ave
Wyndmoor, PA 19038-7444
Phone (267) 971-9409
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28469 | PA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285774364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1408 STOTESBURY AVE",
"city": "WYNDMOOR",
"state": "PA",
"postal_code": "190387444",
"telephone_number": "267-971-9409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6813 GERMANTOWN AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191192112",
"telephone_number": "215-991-6151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUSON",
"first_name": "CHARLES",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "PA",
"license": "28469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
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.