Active NPI
Kellie Greene, LMT, CMMP
- Massage Therapist
- Bala Cynwyd, PA
National Provider Identifier
1518441658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MSG009784
- Practice address
- 29 Bala Ave
Ste 122
Bala Cynwyd, PA 19004-3206 - Phone
- (267) 317-8985
- NPI assigned
- Sep 24, 2018
- Last updated
- Oct 10, 2024
- Sex
- Female
- 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 | MSG009784 | PA | Primary |
Addresses
Primary practice location
29 Bala Ave
Ste 122
Bala Cynwyd, PA 19004-3206
Mailing address
5208 Euclid St
Philadelphia, PA 19131
Phone (610) 809-9009
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 |
|---|---|---|---|
| MSG009784 | PA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728518400000",
"number": "1518441658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5208 EUCLID ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19131",
"telephone_number": "610-809-9009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BALA AVE",
"address_2": "STE 122",
"city": "BALA CYNWYD",
"state": "PA",
"postal_code": "190043206",
"telephone_number": "267-317-8985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "KELLIE",
"credential": "LMT, CMMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-24",
"last_updated": "2024-10-10",
"certification_date": "2024-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "PA",
"license": "MSG009784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bala Cynwyd, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.