Individual provider Active NPI

Lisbeth Shepard

  • Massage Therapist
  • East Aurora, NY
National Provider Identifier
1164964623
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
008138-1 Issued in NY
Practice address
451 North St
East Aurora, NY 14052-1413
Phone
(716) 310-9741
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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 008138-1 NY Primary

Addresses

Primary practice location

451 North St
East Aurora, NY 14052-1413

Mailing address

451 North St
East Aurora, NY 14052-1413
Phone (716) 310-9741

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
008138-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1164964623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 NORTH ST",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140521413",
            "telephone_number": "716-310-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 NORTH ST",
            "city": "EAST AURORA",
            "state": "NY",
            "postal_code": "140521413",
            "telephone_number": "716-310-9741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "LISBETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "008138-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Aurora, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.