Active NPI
Gary S Peroune
- Massage Therapist
- Shaker Heights, OH
National Provider Identifier
1366011025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 33.025255
- Practice address
- 3553 Stoer Rd
Shaker Heights, OH 44122-5154 - Phone
- (216) 312-6322
- NPI assigned
- Jun 17, 2021
- Last updated
- Jun 17, 2021
- 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 | 33.025255 | OH | Primary |
Addresses
Primary practice location
3553 Stoer Rd
Shaker Heights, OH 44122-5154
Mailing address
PO Box 202501
Shaker Heights, OH 44120-8125
Phone (216) 312-6322
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 |
|---|---|---|---|
| 33.025255 | OH | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623888000000",
"number": "1366011025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 202501",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441208125",
"telephone_number": "216-312-6322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3553 STOER RD",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441225154",
"telephone_number": "216-312-6322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEROUNE",
"first_name": "GARY",
"middle_name": "S",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-17",
"last_updated": "2021-06-17",
"certification_date": "2021-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OH",
"license": "33.025255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shaker Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.