Individual provider Active NPI

John S. Casebere II, L.M.P.

  • Massage Therapist
  • Tacoma, WA
National Provider Identifier
1902042211
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00010173 Issued in WA
Practice address
4026 Pacific Ave
Tacoma, WA 98418-7830
Phone
(253) 229-7074
Fax
(253) 473-1142
NPI assigned
Dec 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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 MA00010173 WA Primary

Addresses

Primary practice location

4026 Pacific Ave
Tacoma, WA 98418-7830

Mailing address

PO Box 5962
Tacoma, WA 98415-0962
Phone (253) 229-7074

Other identifiers 1

IdentifierTypeStateIssuer
CA4591OtherWAREGENCE BLUE SHIELD

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
MA00010173WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1902042211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5962",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150962",
            "telephone_number": "253-229-7074",
            "fax_number": "253-473-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4026 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187830",
            "telephone_number": "253-229-7074",
            "fax_number": "253-473-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEBERE",
        "first_name": "JOHN",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "L.M.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-17",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00010173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "CA4591",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.