Active NPI
Shauna Marie Wilson, LMT, AAS
- Massage Therapist
- Huntington, WV
National Provider Identifier
1063737633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 1998-0144
- Practice address
- 5505 US Route 60
Suite 100
Huntington, WV 25705-2070 - Phone
- (304) 412-2165
- NPI assigned
- Apr 7, 2010
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 1998-0144 | WV | Primary |
Addresses
Primary practice location
5505 US Route 60
Suite 100
Huntington, WV 25705-2070
Mailing address
5505 US Route 60
Suite 100
Huntington, WV 25705-2070
Phone (304) 412-2165
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
- Credentials
- Associate of Applied Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1998-0144 | WV | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Living Well Massage Therapy, LLC | Massage Therapist | 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.
-
- Massage Therapist
- Huntington, WV
- NPI 1710314737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344988800000",
"number": "1063737633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5505 US ROUTE 60",
"address_2": "SUITE 100",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257052070",
"telephone_number": "304-412-2165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5505 US ROUTE 60",
"address_2": "SUITE 100",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257052070",
"telephone_number": "304-412-2165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SHAUNA",
"middle_name": "MARIE",
"credential": "LMT, AAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-07",
"last_updated": "2012-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WV",
"license": "1998-0144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.