Active NPI
Gary R Merritt, MASSAGE THERAPIST
- Massage Therapist
- Rochester, NY
National Provider Identifier
1447359211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 011528
- Practice address
- 39 Goodman St N
Rochester, NY 14607-1501 - Phone
- (585) 721-1027
- Fax
- (585) 420-9138
- NPI assigned
- Sep 21, 2006
- 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 | 011528 | NY | Primary |
Addresses
Primary practice location
39 Goodman St N
Rochester, NY 14607-1501
Mailing address
39 Goodman St N
Rochester, NY 14607-1501
Phone (585) 721-1027
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 175871GG | Other | NY | PREFERRED CARE - MASSAGE |
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 |
|---|---|---|---|
| 011528 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447359211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 GOODMAN ST N",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146071501",
"telephone_number": "585-721-1027",
"fax_number": "585-420-9138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 GOODMAN ST N",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146071501",
"telephone_number": "585-721-1027",
"fax_number": "585-420-9138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRITT",
"first_name": "GARY",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "MASSAGE THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "011528",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE - MASSAGE",
"identifier": "175871GG",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.