Active NPI
Beth Ann Shields, MT
- Massage Therapist
- Menomonie, WI
National Provider Identifier
1598046757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 11124-146
- Practice address
- 1309 Stout Rd
Menomonie, WI 54751-2959 - Phone
- (715) 233-6230
- Fax
- (715) 233-6231
- NPI assigned
- Sep 1, 2011
- Sex
- Female
- 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 | 11124-146 | WI | Primary |
Addresses
Primary practice location
1309 Stout Rd
Menomonie, WI 54751-2959
Mailing address
1101 Tainter St
Menomonie, WI 54751-1568
Phone (715) 597-2316
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
- Credentials
- Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11124-146 | WI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314835200000",
"number": "1598046757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 TAINTER ST",
"city": "MENOMONIE",
"state": "WI",
"postal_code": "547511568",
"telephone_number": "715-597-2316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1309 STOUT RD",
"city": "MENOMONIE",
"state": "WI",
"postal_code": "547512959",
"telephone_number": "715-233-6230",
"fax_number": "715-233-6231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "BETH",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-01",
"last_updated": "2011-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WI",
"license": "11124-146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menomonie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.