Individual provider Active NPI

Shannon M Eisert, LMP

  • Massage Therapist
  • Wenatchee, WA
National Provider Identifier
1073768339
Registry record updated Nov 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00021986 Issued in WA
Practice address
630 N Chelan Ave
Suite B-2
Wenatchee, WA 98801-6622
Phone
(509) 665-8363
Fax
(509) 662-7274
NPI assigned
Nov 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2008

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 MA00021986 WA Primary

Addresses

Primary practice location

630 N Chelan Ave
Suite B-2
Wenatchee, WA 98801-6622

Mailing address

1027 Kittitas St
Wenatchee, WA 98801-3409
Phone (509) 264-0102

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
MA00021986WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kapeikis Chiropractic Clinic PS PastSince Jan 1, 2007 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": "1227830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227830400000",
    "number": "1073768339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 KITTITAS ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013409",
            "telephone_number": "509-264-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N CHELAN AVE",
            "address_2": "SUITE B-2",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988016622",
            "telephone_number": "509-665-8363",
            "fax_number": "509-662-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISERT",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-28",
        "last_updated": "2008-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00021986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2008; 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.