Active NPI
Charles McBride
- Massage Therapist
- College Park, MD
National Provider Identifier
1346721594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- M05034
- Practice address
- 4907 Niagara Rd Ste 102
College Park, MD 20740 - Phone
- (301) 747-1802
- NPI assigned
- Aug 26, 2018
- Last updated
- Aug 26, 2018
- 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 | M05034 | MD | Primary |
Addresses
Primary practice location
4907 Niagara Rd Ste 102
College Park, MD 20740
Mailing address
7109 Antock PL
Upper Marlboro, MD 20772-4303
Phone (513) 252-8493
Other practice location 1
7109 Antock Pl
Upper Marlboro, MD 20772-4303
Phone (513) 252-8493
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 |
|---|---|---|---|
| M05034 | MD | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535241600000",
"number": "1346721594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7109 ANTOCK PL",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207724303",
"telephone_number": "513-252-8493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4907 NIAGARA RD STE 102",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "20740",
"telephone_number": "301-747-1802"
}
],
"practiceLocations": [
{
"address_1": "7109 Antock Pl",
"address_purpose": "LOCATION",
"city": "Upper Marlboro",
"state": "MD",
"postal_code": "207724303",
"country_code": "US",
"telephone_number": "513-252-8493",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCBRIDE",
"first_name": "CHARLES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-26",
"last_updated": "2018-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "MD",
"license": "M05034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, MD
- Maryland Sportscare & Rehab LLC (Pivot Physical Therapy of Maryland)
- Vijay Mathura
- Maxi Care OBGYN Associates
- Eric Mba Ngono
- MBS Global Services (Revelation Home Health Care)
- Margaret M. McCabe, AU.D.
- Mary Kathleen McGaffin, CRNP
- Kathleen M. McPhaul, RN
- MD MC Sprout 1 LLC (Elemy)
- Med-Ped Healthcare, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.