Active NPI
Shannon Lebal
- Massage Therapist
- Brookfield, WI
National Provider Identifier
1619327681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3917
- Practice address
- 14665 W Lisbon Rd Ste 1B
Brookfield, WI 53005-1687 - Phone
- (262) 442-6783
- NPI assigned
- Jun 20, 2016
- 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 | 3917 | WI | Primary |
Addresses
Primary practice location
14665 W Lisbon Rd Ste 1B
Brookfield, WI 53005-1687
Mailing address
14665 W Lisbon Rd Ste 1B
Brookfield, WI 53005-1687
Phone (262) 442-6783
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 |
|---|---|---|---|
| 3917 | WI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466380800000",
"number": "1619327681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14665 W LISBON RD STE 1B",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530051687",
"telephone_number": "262-442-6783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14665 W LISBON RD STE 1B",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530051687",
"telephone_number": "262-442-6783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBAL",
"first_name": "SHANNON",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-20",
"last_updated": "2016-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WI",
"license": "3917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.