Individual provider Active NPI

Alexa Loring Shea, D.C.

  • Chiropractor
  • Watertown, MA
National Provider Identifier
1083946578
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3313 Issued in MA
Practice address
200 Dexter Ave Ste 110
Watertown, MA 02472-4238
Phone
(617) 866-8017
NPI assigned
Feb 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 3313 MA
Chiropractor 111N00000X 3313 MA Primary

Addresses

Primary practice location

200 Dexter Ave Ste 110
Watertown, MA 02472-4238

Mailing address

200 Dexter Ave Ste 110
Watertown, MA 02472-4238
Phone (617) 866-8017

Other practice location 1

1820 Turnpike St Ste 200
North Andover, MA 01845-6399
Phone (978) 688-6181

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

LicenseStateTypeSpecialty
3313MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Shea Sports Chiropractic, LLC Sports Physician Past Accepting new patients
Sports Group Physical Therapy Past Accepting new patients
Off-Season Sports & Physical Therapy Inc PastSince Aug 1, 2010 Accepting new patients

Organizations & group practices 3

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": "1265587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1083946578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DEXTER AVE STE 110",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724238",
            "telephone_number": "617-866-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DEXTER AVE STE 110",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724238",
            "telephone_number": "617-866-8017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1820 Turnpike St Ste 200",
            "address_purpose": "LOCATION",
            "city": "North Andover",
            "state": "MA",
            "postal_code": "018456399",
            "country_code": "US",
            "telephone_number": "978-688-6181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEA",
        "first_name": "ALEXA",
        "middle_name": "LORING",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-08",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MA",
            "license": "3313",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.