Individual provider Active NPI

Shanika Wigley, LMT

  • Massage Therapist
  • Jackson, MS
National Provider Identifier
1306532312
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
2940 Issued in MS
Practice address
2084 Dunbarton Dr Ste H
Jackson, MS 39216-5016
Phone
(769) 226-1925
NPI assigned
Apr 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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 2940 MS Primary

Addresses

Primary practice location

2084 Dunbarton Dr Ste H
Jackson, MS 39216-5016

Mailing address

2084 Dunbarton Dr Ste H
Jackson, MS 39216-5016
Phone (769) 226-1925

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
2940MSMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Resilient Therapeutics LLC Massage Therapist CurrentSince Jun 11, 2023 Accepting new patients

Locations

2084 Dunbarton Dr
Ste H
Jackson, MS 39216
Phone (769) 226-1925

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1306532312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2084 DUNBARTON DR STE H",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165016",
            "telephone_number": "769-226-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2084 DUNBARTON DR STE H",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392165016",
            "telephone_number": "769-226-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGLEY",
        "first_name": "SHANIKA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MS",
            "license": "2940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.