Active NPI
Renika Marie Watson
- Massage Therapist
- College Park, MD
National Provider Identifier
1992361380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- M05247
- Practice address
- 4907 Niagara Rd Ste 102
College Park, MD 20740-1100 - Phone
- (240) 412-2974
- NPI assigned
- May 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | M05247 | MD | Primary |
Addresses
Primary practice location
4907 Niagara Rd Ste 102
College Park, MD 20740-1100
Mailing address
7761 Normandy Rd
Hyattsville, MD 20785-2739
Phone (202) 424-8637
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
| License | State | Type | Specialty |
|---|---|---|---|
| M05247 | MD | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557619200000",
"number": "1992361380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7761 NORMANDY RD",
"city": "HYATTSVILLE",
"state": "MD",
"postal_code": "207852739",
"telephone_number": "202-424-8637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4907 NIAGARA RD STE 102",
"city": "COLLEGE PARK",
"state": "MD",
"postal_code": "207401100",
"telephone_number": "240-412-2974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "RENIKA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-12",
"last_updated": "2019-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "MD",
"license": "M05247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.