Active NPI
Calvin Lee Bruce Jr.
- Massage Therapist
- Henrico, VA
National Provider Identifier
1356175152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 0019010556
- Practice address
- 2103 E Parham Rd
Henrico, VA 23228-2235 - Phone
- (434) 865-0215
- NPI assigned
- Aug 26, 2024
- 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 | 0019010556 | VA | Primary |
Addresses
Primary practice location
2103 E Parham Rd
Henrico, VA 23228-2235
Mailing address
5661 Jessup Meadows Dr
North Chesterfield, VA 23234-4188
Phone (434) 865-0215
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 |
|---|---|---|---|
| 0019010556 | VA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1356175152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5661 JESSUP MEADOWS DR",
"city": "NORTH CHESTERFIELD",
"state": "VA",
"postal_code": "232344188",
"telephone_number": "434-865-0215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2103 E PARHAM RD",
"city": "HENRICO",
"state": "VA",
"postal_code": "232282235",
"telephone_number": "434-865-0215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCE",
"first_name": "CALVIN",
"middle_name": "LEE",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-26",
"last_updated": "2024-08-26",
"certification_date": "2024-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "VA",
"license": "0019010556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henrico, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.