Individual provider Active NPI

Nicole Russeck, LMT, CLT, HTP

  • Massage Therapist
  • Doylestown, PA
National Provider Identifier
1710747720
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MSG009326 Issued in PA
Practice address
701 Hyde Park
Doylestown, PA 18902-6612
Phone
(267) 614-1921
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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 MSG009326 PA Primary

Addresses

Primary practice location

701 Hyde Park
Doylestown, PA 18902-6612

Mailing address

11 Cynwyd Dr
Burlington, NJ 08016-2357
Phone (267) 614-1921

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
MSG009326PAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1710747720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CYNWYD DR",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080162357",
            "telephone_number": "267-614-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 HYDE PARK",
            "city": "DOYLESTOWN",
            "state": "PA",
            "postal_code": "189026612",
            "telephone_number": "267-614-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSECK",
        "first_name": "NICOLE",
        "credential": "LMT, CLT, HTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "PA",
            "license": "MSG009326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doylestown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.

Verify at the official NPI Registry.