Active NPI
Shaena Marie Hollomon, LMT, MMP
- Massage Therapist
- Southern Shores, NC
National Provider Identifier
1265821383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 4330
- Practice address
- 5575 N Croatan Hwy
Southern Shores, NC 27949-3996 - Phone
- (252) 722-2713
- NPI assigned
- Jan 13, 2015
- 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 | 4330 | NC | Primary |
Addresses
Primary practice location
5575 N Croatan Hwy
Southern Shores, NC 27949-3996
Mailing address
231 W Lookout Rd
Nags Head, NC 27959-9451
Phone (252) 216-8072
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 |
|---|---|---|---|
| 4330 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421107200000",
"number": "1265821383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "231 W LOOKOUT RD",
"city": "NAGS HEAD",
"state": "NC",
"postal_code": "279599451",
"telephone_number": "252-216-8072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5575 N CROATAN HWY",
"city": "SOUTHERN SHORES",
"state": "NC",
"postal_code": "279493996",
"telephone_number": "252-722-2713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLOMON",
"first_name": "SHAENA",
"middle_name": "MARIE",
"credential": "LMT, MMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-13",
"last_updated": "2015-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NC",
"license": "4330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southern Shores, NC
- Scott Edward Bobrow, D.D.S.
- Cetd Chiropractic Services P.C. (Clearview Chiropractic Wellness Center)
- Clearview Chiropractic Wellness Center
- Dr Donald E McGriff DC PC
- Amy Higgins Feltz, RPH
- Joann NMN Hummers, LCAS,LPC
- Island Acupuncture and Massage Therapy, Inc
- Daniel L Jones, O.D.
- Craig W McGiffin, D.C
- Donald Eugene McGriff, D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.