Charles Clagg, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501010100 Issued in MI

Practice address

19159 Merriman Rd
Livonia, MI 48152

Phone

(248) 477-4408

NPI assigned

Jun 2, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Verdurous Me, LLC

  • Massage Therapist
  • Wixom, MI
  • NPI 1124548185
  NPD (past)
• Verdurous Me, LLC

  • Massage Therapist
  • Wixom, MI
  • NPI 1689126468
  NPD (past)

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1831627876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44284 ARLINGTON RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872144",
            "telephone_number": "734-883-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19159 MERRIMAN RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "248-477-4408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49881 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Wixom",
            "state": "MI",
            "postal_code": "483933309",
            "country_code": "US",
            "telephone_number": "248-229-4016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAGG",
        "first_name": "CHARLES",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-02",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501010100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS",
            "identifier": "7501010100",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hali Citizen, BS
• Marcy Citron, LLC
• City of Livonia
• Civello Spinal Center PLLC
• William B Civello, DC
• Denise Kenny Claiborne, MS, OTR, CHT
• Nicole Clarey, DPT
• Alivia Clark, BEHAVIOR TECHNICIAN
• John W Clark, CCP
• Kelly Clark, DPT

• Massage Therapist in Livonia, MI
• Providers in Livonia, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.