Active NPI
Ian Staggers
- Massage Therapist
- Hyattsville, MD
National Provider Identifier
1356820294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- M04425
- Practice address
- 3501 Hamilton St Ste 205-B
Hyattsville, MD 20782-3961 - Phone
- (301) 741-8075
- NPI assigned
- Aug 10, 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 | M04425 | MD | Primary |
Addresses
Primary practice location
3501 Hamilton St Ste 205-B
Hyattsville, MD 20782-3961
Mailing address
8978 Watchlight CT
Columbia, MD 21045-4223
Phone (301) 741-8075
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 |
|---|---|---|---|
| M04425 | MD | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533859200000",
"number": "1356820294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8978 WATCHLIGHT CT",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210454223",
"telephone_number": "301-741-8075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 HAMILTON ST STE 205-B",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207823961",
"telephone_number": "301-741-8075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAGGERS",
"first_name": "IAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-10",
"last_updated": "2018-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MD",
"license": "M04425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyattsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.