Shane Williams, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

113243 Issued in AK

Practice address

109 Lynch St
Ste B
Wrangell, AK 99929

Phone

(907) 874-3361

NPI assigned

Jun 24, 2019

Last updated

Feb 3, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

State licenses

Practice roles

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.

• Arctic Chiropractic Petersburg

  • Chiropractor
  • Petersburg, AK
  • NPI 1962241349
  NPD (past)
• Arctic Chiropractic Wrangell, LLC

  • Chiropractor
  • Wrangell, AK
  • NPI 1265905475
  NPD (past)

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1932760766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 S COLONY WAY STE 3",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456972",
            "telephone_number": "907-727-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LYNCH ST",
            "address_2": "STE B",
            "city": "WRANGELL",
            "state": "AK",
            "postal_code": "99929",
            "telephone_number": "907-874-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHANE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "113243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Traylor
• Emily Catherine Tryon
• Matthew Thomas Tucker
• Joshua John Van Slyke, APRN-FNP
• Thomas Wetor
• Theodora Vaughn Williams, CDCI
• Daniel Willis
• Jessica Anne Wilson, CARE COORDINATOR
• Wrangell Medical Center
• Carson Jay Yach, MASTER OF EDUCATION

• Massage Therapist in Wrangell, AK
• Providers in Wrangell, AK by specialty
• Massage Therapist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.