Active NPI
Michelle Lynn Massingale, PT
- Physical Therapist
- Phoenix, AZ
National Provider Identifier
1033458765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3764
- Practice address
- 1320 N 10TH St Ste B
Phoenix, AZ 85006-2710 - Phone
- (602) 839-7285
- Fax
- (602) 839-7272
- NPI assigned
- Jan 31, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3764 | AZ | Primary |
Addresses
Primary practice location
1320 N 10TH St Ste B
Phoenix, AZ 85006-2710
Mailing address
1320 N 10TH St Ste B
Phoenix, AZ 85006-2710
Phone (602) 839-7285
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807837 | Medicaid | AZ |
Other names 1
- Shelly Lynn Massingale
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3764 | AZ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383004800000",
"number": "1033458765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 N 10TH ST STE B",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062710",
"telephone_number": "602-839-7285",
"fax_number": "602-839-7272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 N 10TH ST STE B",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062710",
"telephone_number": "602-839-7285",
"fax_number": "602-839-7272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASSINGALE",
"first_name": "MICHELLE",
"middle_name": "LYNN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-31",
"last_updated": "2013-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "3764",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807837",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHELLY",
"last_name": "MASSINGALE",
"middle_name": "LYNN",
"credential": "PT",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.