Active NPI
Matthew Perrello, L.M.P.
- Massage Therapist
- Middlebury, VT
National Provider Identifier
1316224439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60247265
- Practice address
- 152 Maple Street
Suite 203
Middlebury, VT 05753 - Phone
- (802) 349-7565
- NPI assigned
- Nov 3, 2011
- 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 |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MA60247265 | WA | |
| Massage Therapist | 225700000X | MA60247265 | WA | Primary |
Addresses
Primary practice location
152 Maple Street
Suite 203
Middlebury, VT 05753
Mailing address
152 Maple Street
Suite 203
Middlebury, VT 05753
Phone (802) 349-7565
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 |
|---|---|---|---|
| MA60247265 | WA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1316224439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 MAPLE STREET",
"address_2": "SUITE 203",
"city": "MIDDLEBURY",
"state": "VT",
"postal_code": "05753",
"telephone_number": "802-349-7565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 MAPLE STREET",
"address_2": "SUITE 203",
"city": "MIDDLEBURY",
"state": "VT",
"postal_code": "05753",
"telephone_number": "802-349-7565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRELLO",
"first_name": "MATTHEW",
"credential": "L.M.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-03",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "WA",
"license": "MA60247265",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WA",
"license": "MA60247265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middlebury, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.