Tammy Renee Shackelford, MMP

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

5336 Issued in AL

Practice address

600 Energy Center Blvd. Suite 1701
Northport, AL 35473

Phone

(205) 331-4342

NPI assigned

Nov 16, 2022

Last updated

Nov 16, 2022By 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1730898990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ENERGY CENTER BLVD. SUITE 1701",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "35473",
            "telephone_number": "205-331-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ENERGY CENTER BLVD. SUITE 1701",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "35473",
            "telephone_number": "205-331-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKELFORD",
        "first_name": "TAMMY",
        "middle_name": "RENEE",
        "credential": "MMP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AL",
            "license": "5336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "OTHER",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "recoveryroom@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "600 Energy Center Blvd. Suite 1701",
            "city": "Northport",
            "state": "AL",
            "country_code": "US",
            "postal_code": "35473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Massage Therapist in Northport, AL
• Providers in Northport, AL by specialty
• Massage Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.