Active NPI
Steven Elbert Clerico II
- Massage Therapist
- Cherryville, PA
National Provider Identifier
1568944841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MSG012512
- Practice address
- 661 Blue Mountain Dr
Cherryville, PA 18035-9711 - Phone
- (610) 222-6089
- NPI assigned
- Sep 3, 2018
- Last updated
- Aug 31, 2020
- Sex
- Male
- Sole proprietor
- No
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 | MSG012512 | PA | Primary |
Addresses
Primary practice location
661 Blue Mountain Dr
Cherryville, PA 18035-9711
Mailing address
6266 Hillside Rd
Germansville, PA 18053-2035
Phone (570) 687-7503
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 |
|---|---|---|---|
| MSG012512 | PA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598832000000",
"number": "1568944841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6266 HILLSIDE RD",
"city": "GERMANSVILLE",
"state": "PA",
"postal_code": "180532035",
"telephone_number": "570-687-7503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "661 BLUE MOUNTAIN DR",
"city": "CHERRYVILLE",
"state": "PA",
"postal_code": "180359711",
"telephone_number": "610-222-6089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLERICO",
"first_name": "STEVEN",
"middle_name": "ELBERT",
"name_prefix": "Mr.",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-03",
"last_updated": "2020-08-31",
"certification_date": "2020-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "PA",
"license": "MSG012512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.