Leslie M Shaw

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

107614 Issued in KY

Practice address

3005 Dixie Hwy Ste 20
Edgewood, KY 41017-2380

Phone

(407) 212-5814

NPI assigned

Feb 8, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1581120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1093347916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 DIXIE HWY STE 20",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410172380",
            "telephone_number": "407-212-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 DIXIE HWY STE 20",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410172380",
            "telephone_number": "407-212-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "LESLIE",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-08",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "107614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.seaoftranquility.biz",
            "affiliation": "N",
            "address_1": "8172 Mall Rd Ste 205",
            "city": "Florence",
            "state": "KY",
            "country_code": "US",
            "postal_code": "410421400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pratish H Shah, MD
• Anusha Gopalkrishna Shanbhag
• Samar Sharma, M.D.
• Leslie Sharp, LCSW
• Thomas Shaughnessy, M.D.
• Carl Randolph Shelton, MD
• Pamela Marie Shepherd, DPT
• John Carleton Sherman, MD
• Meghan Sherman, M.S.
• Baowen Shi, CNP

• Massage Therapist in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Massage Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.