Active NPI
Lori Ann Shaw, L.M.T.
- Massage Therapist
- Casco, ME
National Provider Identifier
1902059702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT2492
- Practice address
- 5 S Casco Village Rd
Casco, ME 04015-4246 - Phone
- (207) 655-2520
- NPI assigned
- Oct 24, 2008
- Last updated
- Oct 24, 2008
- Sex
- Female
- 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 | MT2492 | ME | Primary |
Addresses
Primary practice location
5 S Casco Village Rd
Casco, ME 04015-4246
Mailing address
32 Jefferson CT
Naples, ME 04055-5044
Phone (207) 632-3189
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200719 | Other | ME | ANTHEM PROVIDER # |
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 |
|---|---|---|---|
| MT2492 | ME | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackpot | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224806400000",
"number": "1902059702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 JEFFERSON CT",
"city": "NAPLES",
"state": "ME",
"postal_code": "040555044",
"telephone_number": "207-632-3189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 S CASCO VILLAGE RD",
"city": "CASCO",
"state": "ME",
"postal_code": "040154246",
"telephone_number": "207-655-2520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "LORI",
"middle_name": "ANN",
"credential": "L.M.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-24",
"last_updated": "2008-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "ME",
"license": "MT2492",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER #",
"identifier": "200719",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Casco, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.