Individual provider Active NPI

Shirley Ann Gerebizza, LMT

  • Massage Therapist
  • McHenry, IL
National Provider Identifier
1013261999
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227.3680406 Issued in IL
Practice address
413 Front St
McHenry, IL 60050-5506
Phone
(815) 759-5927
NPI assigned
Oct 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

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 227.3680406 IL Primary

Addresses

Primary practice location

413 Front St
McHenry, IL 60050-5506

Mailing address

7410 S Rawson Bridge Rd
Cary, IL 60013-1760
Phone (847) 602-0619

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
227.3680406ILMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1013261999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 S RAWSON BRIDGE RD",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600131760",
            "telephone_number": "847-602-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 FRONT ST",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600505506",
            "telephone_number": "815-759-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEREBIZZA",
        "first_name": "SHIRLEY",
        "middle_name": "ANN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.3680406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.