Individual provider Active NPI

Nicholas Paredes

  • Massage Therapist
  • Eatontown, NJ
National Provider Identifier
1689117939
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
18KT00759300 Issued in NJ
Practice address
251 South St
3 Corbett Way
Eatontown, NJ 07724-1865
Phone
(732) 513-2191
NPI assigned
Nov 18, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 18KT00759300 NJ Primary

Addresses

Primary practice location

251 South St
3 Corbett Way
Eatontown, NJ 07724-1865

Mailing address

251 South St
3 Corbett Way
Eatontown, NJ 07724-1865
Phone (732) 513-2191

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

LicenseStateTypeSpecialty
18KT00759300NJMDMassage Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1689117939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 SOUTH ST",
            "address_2": "3 CORBETT WAY",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241865",
            "telephone_number": "732-513-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 SOUTH ST",
            "address_2": "3 CORBETT WAY",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241865",
            "telephone_number": "732-513-2191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAREDES",
        "first_name": "NICHOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-18",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NJ",
            "license": "18KT00759300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.