Shirley Dianne Nicks, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

8450 Butts Canyon Road
Pope Valley, CA 94567

Phone

(707) 965-9242

Fax

(707) 965-9242

NPI assigned

May 1, 2009

Last updated

May 1, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241136000000",
    "number": "1457595639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8450 BUTTS CANYON ROAD",
            "address_2": "PO BOX 146",
            "city": "POPE VALLEY",
            "state": "CA",
            "postal_code": "94567",
            "telephone_number": "707-965-9242",
            "fax_number": "707-965-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8450 BUTTS CANYON ROAD",
            "city": "POPE VALLEY",
            "state": "CA",
            "postal_code": "94567",
            "telephone_number": "707-965-9242",
            "fax_number": "707-965-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKS",
        "first_name": "SHIRLEY",
        "middle_name": "DIANNE",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-01",
        "last_updated": "2009-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Glassford, RN
• John Lindsay Laird, M.D.
• Carmelyn Fatima Maglalang Paguio, RDHAP

• Massage Therapist in Pope Valley, CA
• Providers in Pope Valley, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; 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.