Mariellen L Porter, C.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

RR 2 Box 2172-a
Pine Ridge Road
East Stroudsburg, PA 18301-9636

Phone

(570) 223-2204

Fax

(570) 223-7221

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710005582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 2172-A",
            "address_2": "PINE RIDGE ROAD",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183019636",
            "telephone_number": "570-223-2204",
            "fax_number": "570-223-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 2172-A",
            "address_2": "PINE RIDGE ROAD",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183019636",
            "telephone_number": "570-223-2204",
            "fax_number": "570-223-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "MARIELLEN",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "C.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in East Stroudsburg, PA
• Providers in East Stroudsburg, PA by specialty
• Massage Therapist in Pennsylvania

• 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.

Verify at the official NPI Registry.