Active NPI
Michele Shelbrack, LMT, MMP
- Massage Therapist
- Plainville, CT
National Provider Identifier
1205420528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 005214
- Practice address
- 103 E Main St Ste C
Plainville, CT 06062-1968 - Phone
- (860) 517-8885
- Fax
- (860) 517-8884
- NPI assigned
- Feb 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 005214 | CT | Primary |
Addresses
Primary practice location
103 E Main St Ste C
Plainville, CT 06062-1968
Mailing address
18 Westwoods Ter
Bristol, CT 06010-5522
Phone (860) 919-9366
Other practice location 1
18 Westwoods Ter
Bristol, CT 06010-5522
Phone (860) 919-9366
Other practice location 2
304 Main St
Farmington, CT 06032-2985
Phone (860) 404-2578
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 |
|---|---|---|---|
| 005214 | CT | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anb-Ptsma Holdings, Inc. | Single Specialty | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Physical Therapist
- West Hartford, CT
- NPI 1659453371
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1205420528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 WESTWOODS TER",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060105522",
"telephone_number": "860-919-9366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 E MAIN ST STE C",
"city": "PLAINVILLE",
"state": "CT",
"postal_code": "060621968",
"telephone_number": "860-517-8885",
"fax_number": "860-517-8884"
}
],
"practiceLocations": [
{
"address_1": "18 Westwoods Ter",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "CT",
"postal_code": "060105522",
"country_code": "US",
"telephone_number": "860-919-9366",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "304 Main St",
"address_purpose": "LOCATION",
"city": "Farmington",
"state": "CT",
"postal_code": "060322985",
"country_code": "US",
"telephone_number": "860-404-2578",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHELBRACK",
"first_name": "MICHELE",
"credential": "LMT, MMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-26",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "CT",
"license": "005214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.