Active NPI
Sherita Nicole Bagby McCollum, LMT
- Massage Therapist
- Katy, TX
National Provider Identifier
1912203407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT111427
- Practice address
- 1830 Snake River Rd
Suite B
Katy, TX 77449-1843 - Phone
- (832) 848-1800
- NPI assigned
- Feb 1, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | MT111427 | TX | Primary |
Addresses
Primary practice location
1830 Snake River Rd
Suite B
Katy, TX 77449-1843
Mailing address
1111 Houghton Rd
#1711
Katy, TX 77450-3070
Phone (832) 848-1800
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 |
|---|---|---|---|
| MT111427 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296518400000",
"number": "1912203407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 HOUGHTON RD",
"address_2": "#1711",
"city": "KATY",
"state": "TX",
"postal_code": "774503070",
"telephone_number": "832-848-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 SNAKE RIVER RD",
"address_2": "SUITE B",
"city": "KATY",
"state": "TX",
"postal_code": "774491843",
"telephone_number": "832-848-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGBY MCCOLLUM",
"first_name": "SHERITA",
"middle_name": "NICOLE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-01",
"last_updated": "2011-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT111427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.