Individual provider Active NPI

Marlena Padron Reese, MASSOTHERAPIST

  • Massage Therapist
  • Newport News, VA
National Provider Identifier
1326279100
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0019000957 Issued in VA
Practice address
11010 Warwick Blvd Ste B
Newport News, VA 23601-3222
Phone
(757) 635-6758
NPI assigned
Jul 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X
Nutrition Education Nutritionist 133NN1002X 133NN1002X VA
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 0019000957 VA Primary

Addresses

Primary practice location

11010 Warwick Blvd Ste B
Newport News, VA 23601-3222

Mailing address

11010 Warwick Blvd Ste B
Newport News, VA 23601-3222
Phone (757) 635-6758

Other identifiers 1

IdentifierTypeStateIssuer
332BP00XMedicaidVA

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
133NN1002XVAMDNutrition Education Nutritionist
0019000957VAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1326279100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11010 WARWICK BLVD STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013222",
            "telephone_number": "757-635-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11010 WARWICK BLVD STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013222",
            "telephone_number": "757-635-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "MARLENA",
        "middle_name": "PADRON",
        "name_prefix": "Mrs.",
        "credential": "MASSOTHERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "VA",
            "license": "133NN1002X",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019000957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332BP00X",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.