Active NPI
John Joseph Balletto Jr., LMT
- Massage Therapist
- Pawtucket, RI
National Provider Identifier
1629566823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT-00194
- Practice address
- 545 Pawtucket Ave Ste A116
Pawtucket, RI 02860-6046 - Phone
- (401) 722-9991
- NPI assigned
- Apr 24, 2018
- Last updated
- Apr 24, 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 | MT-00194 | RI | Primary |
Addresses
Primary practice location
545 Pawtucket Ave Ste A116
Pawtucket, RI 02860-6046
Mailing address
545 Pawtucket Avenue
Mailbox 304
Pawtucket, RI 02860-6094
Phone (401) 722-9991
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 |
|---|---|---|---|
| MT-00194 | RI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524528000000",
"number": "1629566823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 PAWTUCKET AVENUE",
"address_2": "MAILBOX 304",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028606094",
"telephone_number": "401-722-9991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 PAWTUCKET AVE STE A116",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028606046",
"telephone_number": "401-722-9991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLETTO",
"first_name": "JOHN",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-24",
"last_updated": "2018-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "RI",
"license": "MT-00194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pawtucket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.