Active NPI
Shannon Roxanne Brunner, LMT
- Massage Therapist
- Jacksonville, FL
National Provider Identifier
1245479575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA48835
- Practice address
- 13812 Bismark LN Lot 946
Jacksonville, FL 32250-1784 - Phone
- (088) 688-3328
- NPI assigned
- Feb 10, 2009
- 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 | MA48835 | FL | Primary |
Addresses
Primary practice location
13812 Bismark LN Lot 946
Jacksonville, FL 32250-1784
Mailing address
13812 Bismark LN Lot 946
Jacksonville, FL 32250-1784
Phone (808) 868-8332
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 |
|---|---|---|---|
| MA48835 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747267200000",
"number": "1245479575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13812 BISMARK LN LOT 946",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322501784",
"telephone_number": "808-868-8332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13812 BISMARK LN LOT 946",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322501784",
"telephone_number": "088-688-3328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNNER",
"first_name": "SHANNON",
"middle_name": "ROXANNE",
"name_prefix": "Mrs.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-10",
"last_updated": "2025-05-15",
"certification_date": "2025-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA48835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.