Active NPI
Qua'Shellea Fairley
- Massage Therapist
- D'Iberville, MS
National Provider Identifier
1467251850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2921
- Practice address
- 10216 3Rd Ave Ste C
Diberville, MS 39540-2543 - Phone
- (228) 296-6130
- Fax
- (228) 296-6130
- NPI assigned
- Mar 10, 2025
- Last updated
- Mar 10, 2025
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 2921 | MS | Primary |
Addresses
Primary practice location
10216 3Rd Ave Ste C
Diberville, MS 39540-2543
Mailing address
890 Motsie Rd Apt 424
Biloxi, MS 39532-9597
Phone (228) 296-6130
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 |
|---|---|---|---|
| 2921 | MS | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741564800000",
"number": "1467251850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "890 MOTSIE RD APT 424",
"city": "BILOXI",
"state": "MS",
"postal_code": "395329597",
"telephone_number": "228-296-6130",
"fax_number": "228-296-6130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10216 3RD AVE STE C",
"city": "DIBERVILLE",
"state": "MS",
"postal_code": "395402543",
"telephone_number": "228-296-6130",
"fax_number": "228-296-6130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRLEY",
"first_name": "QUA'SHELLEA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-10",
"last_updated": "2025-03-10",
"certification_date": "2025-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "MS",
"license": "2921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in D'Iberville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.