Active NPI
Vernon Mabry, MASSAGE THERAPIST
- Massage Therapist
- Silver Spring, MD
National Provider Identifier
1316217664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- M03790
- Practice address
- 1329 Gresham Rd
Silver Spring, MD 20904-1437 - Phone
- (301) 879-1819
- NPI assigned
- Jan 4, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT1077 | DC | |
| Massage Therapist | 225700000X | M03790 | MD | Primary |
Addresses
Primary practice location
1329 Gresham Rd
Silver Spring, MD 20904-1437
Mailing address
1329 Gresham Rd
Silver Spring, MD 20904-1437
Phone (301) 879-1819
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 |
|---|---|---|---|
| MT1077 | DC | MD | Massage Therapist |
| M03790 | MD | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325635200000",
"number": "1316217664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1329 GRESHAM RD",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209041437",
"telephone_number": "301-879-1819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1329 GRESHAM RD",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209041437",
"telephone_number": "301-879-1819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MABRY",
"first_name": "VERNON",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-04",
"last_updated": "2012-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "DC",
"license": "MT1077",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MD",
"license": "M03790",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.