Active NPI
Shawna Tibbs, LMT
- Massage Therapist
- Las Vegas, NV
National Provider Identifier
1104493600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- NVMT.9665
- Practice address
- 9913 Fountain Walk Ave
Las Vegas, NV 89149-3759 - Phone
- (702) 613-9173
- NPI assigned
- Jun 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | NVMT.9665 | NV | Primary |
Addresses
Primary practice location
9913 Fountain Walk Ave
Las Vegas, NV 89149-3759
Mailing address
PO Box 33053
Las Vegas, NV 89133-3053
Phone (702) 613-9173
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
| License | State | Type | Specialty |
|---|---|---|---|
| NVMT.9665 | NV | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622764800000",
"number": "1104493600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33053",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891333053",
"telephone_number": "702-613-9173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9913 FOUNTAIN WALK AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891493759",
"telephone_number": "702-613-9173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIBBS",
"first_name": "SHAWNA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-04",
"last_updated": "2021-06-04",
"certification_date": "2021-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "NV",
"license": "NVMT.9665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.