Active NPI
Jessica M. Shaughnessy-Malloy, L.M.T.
- Specialist
- Haines City, FL
National Provider Identifier
1437400900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA31036
- Practice address
- 101 S 10TH St
Haines City, FL 33844-5303 - Phone
- (863) 412-9197
- NPI assigned
- Sep 25, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA31036 | FL | Primary |
Addresses
Primary practice location
101 S 10TH St
Haines City, FL 33844-5303
Mailing address
101 S 10TH St
Haines City, FL 33844-5303
Phone (863) 412-9197
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 |
|---|---|---|---|
| MA31036 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1437400900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 S 10TH ST",
"city": "HAINES CITY",
"state": "FL",
"postal_code": "338445303",
"telephone_number": "863-412-9197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S 10TH ST",
"city": "HAINES CITY",
"state": "FL",
"postal_code": "338445303",
"telephone_number": "863-412-9197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAUGHNESSY-MALLOY",
"first_name": "JESSICA",
"middle_name": "M.",
"name_prefix": "Mrs.",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-25",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "MA31036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haines City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.