Individual provider Active NPI

Shantelle Angello, LMT

  • Massage Therapist
  • Grand Junction, CO
National Provider Identifier
1194276501
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT.0001984 Issued in CO
Practice address
2646 Patterson Rd
Suite a
Grand Junction, CO 81506-1941
Phone
(970) 248-9833
Fax
(970) 248-9835
NPI assigned
Oct 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 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 MT.0001984 CO Primary

Addresses

Primary practice location

2646 Patterson Rd
Suite a
Grand Junction, CO 81506-1941

Mailing address

2646 Patterson Rd
Suite a
Grand Junction, CO 81506-1941
Phone (970) 248-9833

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
MT.0001984COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Rehabilitation and Occupational Medicine, PLLC Past Accepting new patients
Active Phase Spinal Therapies, PC PastSince May 14, 2007 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1194276501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2646 PATTERSON RD",
            "address_2": "SUITE A",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815061941",
            "telephone_number": "970-248-9833",
            "fax_number": "970-248-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2646 PATTERSON RD",
            "address_2": "SUITE A",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815061941",
            "telephone_number": "970-248-9833",
            "fax_number": "970-248-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELLO",
        "first_name": "SHANTELLE",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "MT.0001984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.