Individual provider Active NPI

Debra Shope, MASSAGE THERAPIST

  • Massage Therapist
  • Bozeman, MT
National Provider Identifier
1083175822
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
1016 Issued in MT
Practice address
9062 Haggerty LN
Bozeman, MT 59715-9258
Phone
(406) 586-1514
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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 1016 MT Primary

Addresses

Primary practice location

9062 Haggerty LN
Bozeman, MT 59715-9258

Mailing address

9062 Haggerty LN
Bozeman, MT 59715-9258
Phone (406) 586-1514

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
1016MTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1083175822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9062 HAGGERTY LN",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597159258",
            "telephone_number": "406-586-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9062 HAGGERTY LN",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597159258",
            "telephone_number": "406-586-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOPE",
        "first_name": "DEBRA",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MT",
            "license": "1016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.

Verify at the official NPI Registry.