Individual provider Active NPI

George Stephen Vukich, L.M.T.

  • Massage Therapist
  • Mogadore, OH
National Provider Identifier
1801104997
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
4856 Issued in OH
Practice address
774 Etter Rd
Mogadore, OH 44260-9692
Phone
(330) 414-3464
NPI assigned
Sep 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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 4856 OH Primary

Addresses

Primary practice location

774 Etter Rd
Mogadore, OH 44260-9692

Mailing address

774 Etter Rd
Mogadore, OH 44260-9692
Phone (330) 414-3464

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
4856OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1801104997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 ETTER RD",
            "city": "MOGADORE",
            "state": "OH",
            "postal_code": "442609692",
            "telephone_number": "330-414-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 ETTER RD",
            "city": "MOGADORE",
            "state": "OH",
            "postal_code": "442609692",
            "telephone_number": "330-414-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VUKICH",
        "first_name": "GEORGE",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "4856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mogadore, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.