Lillian Musungu Shiraku

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

12970 63Rd Ave N
Maple Grove, MN 55369-6001

Phone

(507) 513-1860

NPI assigned

Sep 8, 2020

Last updated

Sep 8, 2020By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599523200000",
    "number": "1871108704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1363 10TH ST NW APT 301",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551126747",
            "telephone_number": "507-513-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12970 63RD AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696001",
            "telephone_number": "507-513-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAKU",
        "first_name": "LILLIAN",
        "middle_name": "MUSUNGU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2020-09-08",
        "certification_date": "2020-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Silver Spring Services LLC

• Massage Therapist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Massage Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; 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.