Active NPI
Peter Shor
- Massage Therapist
- Charles Town, WV
National Provider Identifier
1457894081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2002-1082
- Practice address
- 44 Paddock PL
Charles Town, WV 25414-5329 - Phone
- (304) 997-4161
- NPI assigned
- Nov 30, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 2002-1082 | WV | Primary |
Addresses
Primary practice location
44 Paddock PL
Charles Town, WV 25414-5329
Mailing address
44 Paddock PL
Charles Town, WV 25414-5329
Phone (304) 997-4161
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 |
|---|---|---|---|
| 2002-1082 | WV | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Developmental Evolution, LLC | 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 and National Provider Directory roles.
-
- Clinical Social Worker
- Charles Town, WV
- NPI 1710391057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480464000000",
"number": "1457894081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 PADDOCK PL",
"city": "CHARLES TOWN",
"state": "WV",
"postal_code": "254145329",
"telephone_number": "304-997-4161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 PADDOCK PL",
"city": "CHARLES TOWN",
"state": "WV",
"postal_code": "254145329",
"telephone_number": "304-997-4161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOR",
"first_name": "PETER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-30",
"last_updated": "2016-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WV",
"license": "2002-1082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charles Town, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.