Individual provider Active NPI

Taryn Shelby

  • Massage Therapist
  • Jacksonville, FL
National Provider Identifier
1295479376
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA99429 Issued in FL
Practice address
9651 Crosshill Blvd
Jacksonville, FL 32222-5856
Phone
(239) 309-6504
NPI assigned
Apr 25, 2022
Last updated
Apr 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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 MA99429 FL Primary

Addresses

Primary practice location

9651 Crosshill Blvd
Jacksonville, FL 32222-5856

Mailing address

1351 Summerbrook Dr
Middleburg, FL 32068-8424

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
MA99429FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1295479376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 SUMMERBROOK DR",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9651 CROSSHILL BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322225856",
            "telephone_number": "239-309-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELBY",
        "first_name": "TARYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA99429",
            "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 Apr 25, 2022; 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.