Individual provider Active NPI

Shawnta Halstead-Passley

  • Massage Therapist
  • Winder, GA
National Provider Identifier
1740173343
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
014878 Issued in GA
Practice address
120 Hyde Park
Winder, GA 30680-4543
Phone
(347) 458-9662
NPI assigned
Jun 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 014878 GA Primary

Addresses

Primary practice location

120 Hyde Park
Winder, GA 30680-4543

Mailing address

120 Hyde Park
Winder, GA 30680-4543
Phone (347) 458-9662

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

LicenseStateTypeSpecialty
014878GAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1740173343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HYDE PARK",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306804543",
            "telephone_number": "347-458-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HYDE PARK",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306804543",
            "telephone_number": "347-458-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALSTEAD-PASSLEY",
        "first_name": "SHAWNTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "014878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winder, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.