Individual provider Active NPI

Shanice Tipps, MT147709

  • Massage Therapist
  • Dallas, TX
National Provider Identifier
1154296820
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT147709 Issued in TX
Practice address
9030 Markville Dr Apt 4135
Dallas, TX 75243-3550
Phone
(469) 618-3434
NPI assigned
Oct 10, 2025
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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 MT147709 TX Primary

Addresses

Primary practice location

9030 Markville Dr Apt 4135
Dallas, TX 75243-3550

Mailing address

9030 Markville Dr Apt 4135
Dallas, TX 75243-3550
Phone (469) 618-3434

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
MT147709TXMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1760054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1154296820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 MARKVILLE DR APT 4135",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433550",
            "telephone_number": "469-618-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9030 MARKVILLE DR APT 4135",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752433550",
            "telephone_number": "469-618-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPS",
        "first_name": "SHANICE",
        "credential": "MT147709",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-10",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT147709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.