Maureen A Shaw, MS, ATC, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA34636 Issued in FL

Practice address

3577 Lake Emma Rd
Suite 109
Lake Mary, FL 32746-2056

Phone

(407) 936-0314

Fax

(407) 936-0316

NPI assigned

Oct 2, 2006

Last updated

May 28, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Envision Physical Therapy, Inc

  • Clinic/Center
  • Lake Mary, FL
  • NPI 1437301025
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1679666184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2697 BELLEWATER PLACE",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "32765",
            "telephone_number": "407-923-5495",
            "fax_number": "928-223-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 LAKE EMMA RD",
            "address_2": "SUITE 109",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462056",
            "telephone_number": "407-936-0314",
            "fax_number": "407-936-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "MAUREEN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MS, ATC, LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL1326",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA34636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Shamo, OTR/L
• Balaji Shanmugam, MD
• Sampathkumar Shanmugham, M.D.
• Rajni Sharma, NP
• Imani Jaunay Sharpe
• Nancy E Shaw, MSW
• Rebecca Shedden, ARNP
• Cheryl Sheffield, OTR
• Asad A. Sheikh, M.D.
• Sheila L Scott, Ap

• Massage Therapist in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.