Individual provider Active NPI

Tara Jane Pandos, LMT

  • Massage Therapist
  • Cleveland, OH
National Provider Identifier
1942513593
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
17633 Issued in OH
Practice address
3366 E 55TH St
Cleveland, OH 44127-1638
Phone
(216) 271-1133
Fax
(216) 271-1325
NPI assigned
Jul 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 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 17633 OH Primary

Addresses

Primary practice location

3366 E 55TH St
Cleveland, OH 44127-1638

Mailing address

1287 Jackson Ave
Lakewood, OH 44107-2730
Phone (216) 221-6275

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
17633OHMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Broadway Chiropractic and Therapy Center Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1942513593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1287 JACKSON AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072730",
            "telephone_number": "216-221-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3366 E 55TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271638",
            "telephone_number": "216-271-1133",
            "fax_number": "216-271-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDOS",
        "first_name": "TARA",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "17633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.