Mellow Massage LTD.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MELLOW MASSAGE LTD.

Doing business as

Mellow Massage Wellness Center

Practice address

4023 Ridge Ave
Philadelphia, PA 19129-1544

Phone

(856) 297-5085

NPI assigned

Mar 10, 2022

Last updated

Mar 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gerrae L Simons Miller

Title

Owner

Phone

(856) 297-5085

Specialties & licenses 1

Addresses

Other names 1

• Mellow Massage Wellness Center Doing business as

Electronic endpoints 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jenelle Green

  • Massage Therapist
  • Philadelphia, PA
  • NPI 1952039273
  NPD
• Malila Myers

  • Massage Therapist
  • Philadelphia, PA
  • NPI 1235867896
  NPD
• Sierra Singleton

  • Massage Therapist
  • Philadelphia, PA
  • NPI 1336876655
  NPD
• Elvin Torres

  • Massage Therapist
  • Philadelphia, PA
  • NPI 1699403220
  NPD

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1295483147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E WALNUT LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191442005",
            "telephone_number": "856-297-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291544",
            "telephone_number": "856-297-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELLOW MASSAGE LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "SIMONS MILLER",
        "authorized_official_first_name": "GERRAE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-297-5085"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@mellowmassage.com",
            "affiliation": "N",
            "endpointDescription": "company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "132 E Walnut Ln",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191442005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mellow Massage Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steven Meller, MD
• Megan Mellon-Stanton
• John Thomas Mellor, MD
• Xochitl Mellor, MD
• Patrick Mellors
• Barry E Melman, D.M.D.
• Christopher Michael Melnic, MD
• Jessamyn Ann Melnicoff, CRNP (NURSE PRACT)
• Andrew R. Melnyk, M.D.
• Natividad Melo, BA

• Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.