Individual provider Active NPI

Shannon Louise Sexton Potter, L.M.T.

  • Massage Therapist
  • Putnam, CT
National Provider Identifier
1861834301
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
29011535 Issued in CT
Practice address
58 Pomfret St
Putnam, CT 06260-1888
Phone
(603) 315-0525
NPI assigned
Jul 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 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 29011535 CT Primary

Addresses

Primary practice location

58 Pomfret St
Putnam, CT 06260-1888

Mailing address

31 Canterbury Rd
Brooklyn, CT 06234-1901
Phone (603) 315-0525

Other identifiers 2

IdentifierTypeStateIssuer
29011535OtherCTCT
MT01810OtherRILICENSE

Other names 1

  • Shannon Louise Sexton Former name

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
29011535CTMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1861834301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CANTERBURY RD",
            "city": "BROOKLYN",
            "state": "CT",
            "postal_code": "062341901",
            "telephone_number": "603-315-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 POMFRET ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062601888",
            "telephone_number": "603-315-0525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEXTON POTTER",
        "first_name": "SHANNON",
        "middle_name": "LOUISE",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CT",
            "license": "29011535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT",
            "identifier": "29011535",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MT01810",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SEXTON",
            "middle_name": "LOUISE",
            "credential": "L.M.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Putnam, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.