Lisa Latreasa Star Sheridan, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

90275 Issued in CA

Practice address

1252 Airport Park BLD C5
Ukiah, CA 95482

Phone

(707) 462-9448

NPI assigned

Dec 19, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Barr Family Chiropractic

  • Chiropractor
  • Ukiah, CA
  • NPI 1558784447
  NPD (past)

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1689386070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 W OAK ST",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "95490",
            "telephone_number": "707-354-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1252 AIRPORT PARK BLD C5",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "95482",
            "telephone_number": "707-462-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "LISA",
        "middle_name": "LATREASA STAR",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "90275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisasheridan@willitsunified.com",
            "affiliation": "N",
            "endpointDescription": "Lisasheridan@willitsunified.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1252 Airport Park BLD c5",
            "city": "Ukiah",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bethany Faith Sheley, M.ED.
• Coni Shepard
• Michael Shepard, RAS
• Hillary Shephard
• Barry Sheppard, MD
• Jessica N. Sherosick-Dragovic
• Kinderlynn Shields
• Gurpreet K Shires, APRN-CNP
• Deja Sholk
• Marli Docarmo Shoop, LCSW

• Massage Therapist in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.