Active NPI
Shareeda Allen
- Massage Therapist
- East Setauket, NY
National Provider Identifier
1265964506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 025052
- Practice address
- 1386 Route 25a
1386 RT 25a
East Setauket, NY 11733 - Phone
- (631) 751-2374
- NPI assigned
- Mar 28, 2017
- Last updated
- Mar 30, 2017
- Sex
- Female
- Sole proprietor
- No
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 | 025052 | NY | Primary |
Addresses
Primary practice location
1386 Route 25a
1386 RT 25a
East Setauket, NY 11733
Mailing address
1386 RT 25a
North Shore Therapeutic Massage and Wellness
East Setauket, NY 11733
Phone (631) 751-2374
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 |
|---|---|---|---|
| 025052 | NY | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Therapeutic Massage P.C. | Massage Therapist | 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.
-
- Massage Therapist
- East Setauket, NY
- NPI 1306297080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490832000000",
"number": "1265964506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1386 RT 25A",
"address_2": "NORTH SHORE THERAPEUTIC MASSAGE AND WELLNESS",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "11733",
"telephone_number": "631-751-2374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1386 ROUTE 25A",
"address_2": "1386 RT 25A",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "11733",
"telephone_number": "631-751-2374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "SHAREEDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-28",
"last_updated": "2017-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NY",
"license": "025052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Setauket, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.