Active NPI
Timothy J Lisbon
- Massage Therapist
- Shepherdstown, WV
National Provider Identifier
1881572147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 2015-3355
- Practice address
- 129 E German St Ste C200C201
Shepherdstown, WV 25443-3528 - Phone
- (304) 860-0701
- NPI assigned
- Aug 25, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 2015-3355 | WV | Primary |
Addresses
Primary practice location
129 E German St Ste C200C201
Shepherdstown, WV 25443-3528
Mailing address
11 General Early Dr
Harpers Ferry, WV 25425-3069
Phone (703) 216-5164
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2015-3355 | WV | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756080000000",
"number": "1881572147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 GENERAL EARLY DR",
"city": "HARPERS FERRY",
"state": "WV",
"postal_code": "254253069",
"telephone_number": "703-216-5164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 E GERMAN ST STE C200C201",
"city": "SHEPHERDSTOWN",
"state": "WV",
"postal_code": "254433528",
"telephone_number": "304-860-0701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISBON",
"first_name": "TIMOTHY",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-25",
"last_updated": "2025-08-25",
"certification_date": "2025-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WV",
"license": "2015-3355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shepherdstown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.