Active NPI
Shelly Ly
- Massage Therapist
- Elk Grove, CA
National Provider Identifier
1144760422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 34220
- Practice address
- 9108 Laguna Main St Ste 1a
Elk Grove, CA 95758-7450 - Phone
- (916) 421-4117
- NPI assigned
- Mar 6, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 34220 | CA | Primary |
Addresses
Primary practice location
9108 Laguna Main St Ste 1a
Elk Grove, CA 95758-7450
Mailing address
8205 Orelli CT
Sacramento, CA 95828-7562
Phone (916) 230-7797
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 |
|---|---|---|---|
| 34220 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566172800000",
"number": "1144760422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8205 ORELLI CT",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958287562",
"telephone_number": "916-230-7797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9108 LAGUNA MAIN ST STE 1A",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957587450",
"telephone_number": "916-421-4117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "SHELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-06",
"last_updated": "2019-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "34220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.