Individual provider Active NPI

Colleena Lee Fox, LMT

  • Massage Therapist
  • Shelbyville, IL
National Provider Identifier
1457817652
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
227.020955 Issued in IL
Practice address
950 N 1800 East Rd
Shelbyville, IL 62565-4219
Phone
(217) 460-0931
NPI assigned
Feb 13, 2019
Last updated
Feb 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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 227.020955 IL Primary

Addresses

Primary practice location

950 N 1800 East Rd
Shelbyville, IL 62565-4219

Mailing address

950 N 1800 East Rd
Shelbyville, IL 62565-4219
Phone (217) 460-0931

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
227.020955ILMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1457817652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N 1800 EAST RD",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625654219",
            "telephone_number": "217-460-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N 1800 EAST RD",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625654219",
            "telephone_number": "217-460-0931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "COLLEENA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-13",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227.020955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; 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.