Shannon Irene Smith

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

10364 Issued in SC

Practice address

1625 Lake Murray Blvd
Columbia, SC 29212-8626

Phone

(803) 238-9464

NPI assigned

Mar 10, 2021

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1972188027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 MAYLAND CT",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632116",
            "telephone_number": "803-238-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 LAKE MURRAY BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292128626",
            "telephone_number": "803-238-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHANNON",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "SC",
            "license": "10364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy Hampton Smith, DNP, FNP-BC
• Ryan Smith, PTA
• Sarah Shealy Smith, ED.S., LPC
• Shakidia Smith
• Shanna Michella Smith
• Sharee Carter Smith, PHARMD
• Sharon Lynn Smith
• Sheronda Quiller Smith
• Sidney Terrell Smith, MD
• Sinjin Kyle Smith

• Massage Therapist in Columbia, SC
• Providers in Columbia, SC by specialty
• Massage Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.