Individual provider Active NPI

Shulan Zhang, LMT

  • Massage Therapist
  • St Augustine, FL
National Provider Identifier
1609762574
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
96570 Issued in FL
Practice address
804 Anastasia Blvd Unit a
St Augustine, FL 32080-4618
Phone
(904) 755-5068
NPI assigned
Jun 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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 96570 FL Primary

Addresses

Primary practice location

804 Anastasia Blvd Unit a
St Augustine, FL 32080-4618

Mailing address

3979 Meadowview Dr N
Jacksonville, FL 32225-1694
Phone (904) 755-5068

Other identifiers 1

IdentifierTypeStateIssuer
96570OtherFLMASSAGE THERAPIST LICENSE

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
96570FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
New Lifestyle, Inc. Massage Therapist CurrentSince Jun 23, 2025 Accepting new patients

Locations

804 Anastasia Blvd
#A
Saint Augustine, FL 32080
Phone (904) 755-5068

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.

NPI Registry JSON

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1609762574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3979 MEADOWVIEW DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322251694",
            "telephone_number": "904-755-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 ANASTASIA BLVD UNIT A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320804618",
            "telephone_number": "904-755-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "SHULAN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "96570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPIST LICENSE",
            "identifier": "96570",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.