Active NPI
Shawnda Green, LMT
- Massage Therapist
- New Port Richey, FL
National Provider Identifier
1699255737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA90312
- Practice address
- 4636 Glissade Dr
New Port Richey, FL 34652-5319 - Phone
- (727) 495-3650
- NPI assigned
- Aug 17, 2018
- 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 | MA90312 | FL | Primary |
Addresses
Primary practice location
4636 Glissade Dr
New Port Richey, FL 34652-5319
Mailing address
8414 Goldome Dr
Port Richey, FL 34668-3320
Phone (727) 495-3650
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 |
|---|---|---|---|
| MA90312 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534464000000",
"number": "1699255737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8414 GOLDOME DR",
"city": "PORT RICHEY",
"state": "FL",
"postal_code": "346683320",
"telephone_number": "727-495-3650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4636 GLISSADE DR",
"city": "NEW PORT RICHEY",
"state": "FL",
"postal_code": "346525319",
"telephone_number": "727-495-3650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "SHAWNDA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-17",
"last_updated": "2018-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA90312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Port Richey, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.