Shannon Bohanek

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MAS4899 Issued in ID

Practice address

2151 W Hayden Ave
Hayden, ID 83835-7414

Phone

(208) 762-6772

NPI assigned

Dec 6, 2022

Sex

Female

Sole proprietor

No

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 and National Provider Directory roles.

• Balanced Body Massage

  • Massage Therapist
  • Hayden, ID
  • NPI 1821982950
  NPD
• Body Tech Massage & Wellness

  • Primary Care Clinic/Center
  • Hayden, ID
  • NPI 1073120317
  NPD

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1821709239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 W HAYDEN AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357414",
            "telephone_number": "208-762-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 W HAYDEN AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838357414",
            "telephone_number": "208-762-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANEK",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MAS4899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler J Blackwelder, DPT
• Michael Aaron Bloom, DMD
• Bethany Bloomer
• Body Tech Massage & Wellness
• Rachael Susan Boelke, MAS-4345 MA 61150034
• Adam Michael Borg, PT
• Jessica Borges, LM
• Roberta Boyd, LPC
• Carolyn P Brainard, LMP
• Jennifer Dawn Brakeman, LM

• Massage Therapist in Hayden, ID
• Providers in Hayden, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.