Individual provider Active NPI

Matthew Shale, MA

  • Massage Therapist
  • Tamarac, FL
National Provider Identifier
1891181889
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA62042 Issued in FL
Practice address
7310 W McNab Rd
Suite 107
Tamarac, FL 33321-5332
Phone
(954) 657-8342
Fax
(954) 657-8516
NPI assigned
Apr 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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 MA62042 FL Primary

Addresses

Primary practice location

7310 W McNab Rd
Suite 107
Tamarac, FL 33321-5332

Mailing address

7310 W McNab Rd
Suite 107
Tamarac, FL 33321-5332
Phone (954) 657-8342

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
MA62042FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1891181889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 W MCNAB RD",
            "address_2": "SUITE 107",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333215332",
            "telephone_number": "954-657-8342",
            "fax_number": "954-657-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 W MCNAB RD",
            "address_2": "SUITE 107",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333215332",
            "telephone_number": "954-657-8342",
            "fax_number": "954-657-8516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALE",
        "first_name": "MATTHEW",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA62042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.