Individual provider Active NPI

Antoinette Skelly, LMT

  • Massage Therapist
  • Saint Clair, MI
National Provider Identifier
1174454631
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7501015569 Issued in MI
Practice address
1918 Jackson St
Saint Clair, MI 48079-5278
Phone
(810) 674-0556
NPI assigned
May 26, 2026
Last updated
May 26, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2026

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 7501015569 MI Primary

Addresses

Primary practice location

1918 Jackson St
Saint Clair, MI 48079-5278

Mailing address

1918 Jackson St
Saint Clair, MI 48079-5278
Phone (810) 674-0556

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
7501015569MIMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1779753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1174454631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 JACKSON ST",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480795278",
            "telephone_number": "810-674-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 JACKSON ST",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480795278",
            "telephone_number": "810-674-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELLY",
        "first_name": "ANTOINETTE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-26",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501015569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; 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.