Active NPI
Ezell Kent
- Massage Therapist
- Severna Park, MD
National Provider Identifier
1336097658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- R01522
- Practice address
- 692B Ritchie Hwy Ste 104
Severna Park, MD 21146-3971 - Phone
- (443) 474-3631
- Fax
- (410) 874-0131
- NPI assigned
- Mar 20, 2026
- 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 | R01522 | MD | Primary |
Addresses
Primary practice location
692B Ritchie Hwy Ste 104
Severna Park, MD 21146-3971
Mailing address
692B Ritchie Hwy Ste 104
Severna Park, MD 21146-3971
Phone (443) 474-3631
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 |
|---|---|---|---|
| R01522 | MD | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773964800000",
"number": "1336097658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "692B RITCHIE HWY STE 104",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211463971",
"telephone_number": "443-474-3631",
"fax_number": "410-874-0131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "692B RITCHIE HWY STE 104",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211463971",
"telephone_number": "443-474-3631",
"fax_number": "410-874-0131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENT",
"first_name": "EZELL",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-03-20",
"last_updated": "2026-03-20",
"certification_date": "2026-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MD",
"license": "R01522",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severna Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.