Shannon Bush, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

169822 Issued in AK

Practice address

3161 E Palmer Wasilla Hwy Ste 1a
Wasilla, AK 99654-7271

Phone

(360) 907-1654

NPI assigned

Jan 28, 2021

Last updated

Aug 20, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Body Madix Massage Therapy LLC

  • Massage Therapist
  • Wasilla, AK
  • NPI 1144056680
  NPD Authorized official

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1730770298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670202",
            "city": "CHUGIAK",
            "state": "AK",
            "postal_code": "995670202",
            "telephone_number": "360-907-1654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 E PALMER WASILLA HWY STE 1A",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547271",
            "telephone_number": "360-907-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "SHANNON",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "169822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell Burlingame, PT, MS
• Regina Burns, LMT
• Christine Dawn Burt-Burger
• Kyle Burton
• Kimberly Kay Bush, PTA
• Debra Darlene Bushnell, ANP
• Sean Joseph Butler
• Shawn Daniel Butler, PT
• Stephanie Button, MSW
• Dina Byuller

• Massage Therapist in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.