Active NPI
Shirlene Davis, LMT
- Massage Therapist
- Fairplay, CO
National Provider Identifier
1588034854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT.0012602
- Practice address
- 295 5TH Street
#7
Fairplay, CO 80440 - Phone
- (719) 838-0725
- NPI assigned
- Sep 30, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| MT.0012602 | CO | MD | Massage Therapist |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT.0012602 | CO | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
295 5TH Street
#7
Fairplay, CO 80440
Mailing address
PO Box 1572
Fairplay, CO 80440-1572
Phone (719) 838-0725
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 30, 2015.
{
"created_epoch": "1443571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443571200000",
"number": "1588034854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1572",
"city": "FAIRPLAY",
"state": "CO",
"postal_code": "804401572",
"telephone_number": "719-838-0725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 5TH STREET",
"address_2": "#7",
"city": "FAIRPLAY",
"state": "CO",
"postal_code": "80440",
"telephone_number": "719-838-0725"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SHIRLENE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-30",
"last_updated": "2015-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CO",
"license": "MT.0012602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairplay, CO
- Children'S Trauma Center, LLC
- Conifer Counseling and Therapy Services, Inc
- Conifer Counseling and Therapy Services, Inc
- Connect Movement Center LLC
- County of Park Dba Park County Public Health
- Rebecka F Dinwoodie
- Diversus Health Inc
- Diversus Health Inc
- Amygrace Edwards, R.N.
- Carrie Danine Fabel, CMT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.