Individual provider Active NPI

Shauna Renee Lillywhite, LMT

  • Massage Therapist
  • Gainesville, FL
National Provider Identifier
1326192881
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA45074 Issued in FL
Practice address
4820 Newberry Road
Gainesville, FL 32609
Phone
(352) 373-2116
Fax
(352) 373-1507
NPI assigned
Jan 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA45074 FL Primary

Addresses

Primary practice location

4820 Newberry Road
Gainesville, FL 32609

Mailing address

621 SE 73Rd Terr
Gainesville, FL 32641
Phone (352) 374-8532

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
MA45074FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Request Physical Therapy 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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326192881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 SE 73RD TERR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32641",
            "telephone_number": "352-374-8532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 NEWBERRY ROAD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32609",
            "telephone_number": "352-373-2116",
            "fax_number": "352-373-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILLYWHITE",
        "first_name": "SHAUNA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA45074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.