Active NPI
Lisa Shea, DC
- Chiropractor
- Springfield, MA
National Provider Identifier
1336121904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1425
- Practice address
- 230 Forest Park Ave
Springfield, MA 01108-2034 - Phone
- (413) 733-0778
- NPI assigned
- Nov 18, 2005
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1425 | MA | Primary |
Addresses
Primary practice location
230 Forest Park Ave
Springfield, MA 01108-2034
Mailing address
230 Forest Park Ave
Springfield, MA 01108-2034
Phone (413) 733-0778
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4253232 | Other | AETNA | |
| 767546 | Other | TUFTS HEALTH PLAN | |
| Y36015 | Other | MA | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1425 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336121904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 FOREST PARK AVE",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011082034",
"telephone_number": "413-733-0778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 FOREST PARK AVE",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011082034",
"telephone_number": "413-733-0778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEA",
"first_name": "LISA",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "1425",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4253232",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "767546",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "Y36015",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
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.