Individual provider Active NPI

Shareese Miller, MT

  • Massage Therapist
  • Saint Paul, MN
National Provider Identifier
1861258832
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
TE97AQUI Issued in MN
Practice address
996 Rose Ave E
Saint Paul, MN 55106-2627
Phone
(612) 601-6985
NPI assigned
Feb 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 TE97AQUI MN Primary

Addresses

Primary practice location

996 Rose Ave E
Saint Paul, MN 55106-2627

Mailing address

3541 Lyndale Ave S
Minneapolis, MN 55408-4159
Phone (612) 824-1829

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
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
TE97AQUIMNMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Moses S M Smith Chiropractic LLC CurrentSince Mar 3, 2024 Accepting new patients
Lucky Cat Acupuncture and Herbal Medicine PastSince Mar 3, 2024 Accepting new patients

Locations

3541 Lyndale Ave S
Minneapolis, MN 55408
Phone (612) 824-1829

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1861258832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3541 LYNDALE AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084159",
            "telephone_number": "612-824-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "996 ROSE AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551062627",
            "telephone_number": "612-601-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SHAREESE",
        "name_prefix": "Ms.",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MN",
            "license": "TE97AQUI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.