Active NPI
Shauna M Brown, AT, LMT, CSCS
- Athletic Trainer
- Phoenix, AZ
National Provider Identifier
1629587696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1373
- Practice address
- 4221 E Chandler Blvd Ste 116
Phoenix, AZ 85048-8878 - Phone
- (541) 771-8040
- NPI assigned
- Sep 21, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 17519 | AZ | |
| Athletic Trainer | 2255A2300X | 1373 | AZ | Primary |
Addresses
Primary practice location
4221 E Chandler Blvd Ste 116
Phoenix, AZ 85048-8878
Mailing address
4221 E Chandler Blvd Ste 116
Phoenix, AZ 85048-8878
Phone (541) 771-8040
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 |
|---|---|---|---|
| 1373 | AZ | MD | Optometrist |
| 17519 | AZ | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505952000000",
"number": "1629587696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4221 E CHANDLER BLVD STE 116",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850488878",
"telephone_number": "541-771-8040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4221 E CHANDLER BLVD STE 116",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850488878",
"telephone_number": "541-771-8040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "SHAUNA",
"middle_name": "M",
"credential": "AT, LMT, CSCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-21",
"last_updated": "2017-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AZ",
"license": "17519",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "1373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.