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Deactivated NPI 1518483775 Deactivated / Inactive NPI Male Practitioner

Shane Maroon , CMT

Massage Therapist • Exeter, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Shane Maroon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 19, 2017
NPI Deactivation Date March 02, 2022
Total Practice Duration ~5 Years of Practice (2017 – 2022)

Professional Overview & Biography Verified Profile Summary

Shane Maroon, CMT was a registered Massage Therapist practicing in Exeter, CA. Throughout an active medical career spanning 5 years, Shane Maroon provided care at the practice location at 330 E PINE ST until profile deactivation on 2022-03-02.

Practice Location & Contact Primary Location

Practice Address

330 E Pine St

Exeter, CA 932211838

Telephone 5599078111
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Massage Therapist in Exeter, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 1.0 Yrs
Regional Practice Density
7 Specialists

Practicing in Exeter, CA (5197 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Massage Therapist Primary Specialty

NUCC Taxonomy Code: 225700000X

State License CA 74051

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

7 Associated Practitioners
NPI 1154344927

Doctor of Medicine (M.D.)

Simranpreet Kaur

Nurse Practitioner

NPI 1518836030
Kourtney Umphfres , PA-C

Physician Assistant

NPI 1528028321

Physician Assistant (Certified)

NPI 1750369401

Doctor of Medicine (M.D.)

Sheila Scheinesson , PA-C

Physician Assistant

NPI 1891748752

Physician Assistant (Certified)

Leslee Heuer , NP

Nurse Practitioner

NPI 1962806521

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
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NPI Profile Deactivated March 02, 2022

Record deactivated on March 02, 2022

NPI Profile Active October 02, 2017

NPI status registered as active in NPPES database

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Updated Practice Location October 02, 2017

Registered at 330 E PINE ST, EXETER, CA 932211838 (Tel: 5595922134)

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Updated Business Mailing Address October 02, 2017

Registered at 37535 CARDINAL LN, SQUAW VALLEY, CA 936759723 (Tel: 5599078111)

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Provider Name / Credentials Updated October 02, 2017

Recorded as SHANE MAROON, CMT

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 02, 2017

Massage Therapist (License #74051 in CA)

NPI Profile Active August 19, 2017

NPI status registered as active in NPPES database

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Updated Practice Location August 19, 2017

Registered at 330 E PINE ST, EXETER, CA 932211838 (Tel: 5599078111)

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Updated Business Mailing Address August 19, 2017

Registered at 37535 CARDINAL LN, SQUAW VALLEY, CA 936759723 (Tel: 5599078111)

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Provider Name / Credentials Updated August 19, 2017

Recorded as SHANE MAROON, CMT

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2017

Massage Therapist (License #74051 in CA)

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Initial NPI Registration & Enumeration August 19, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1518483775
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 19, 2017
Last Update: August 19, 2017
Deactivation Date: March 02, 2022

Mailing Address

37535 Cardinal Ln

Squaw Valley, CA 936759723

Phone: 5599078111

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.