MEDICARE: SHAKIA CHANEL THE PADGETT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT008319	GA

General Provider Information

NPI Number	:	1558213132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAKIA CHANEL THE PADGETT

Provider Business Mailing Address
First Line	:	2727 WICKLOW DR
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-3645
Country	:	US
Telephone Number	:	678-913-3958
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 WICKLOW DR
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30909-3645
Country	:	US
Telephone Number	:	678-913-3958
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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Directions to “ SHAKIA CHANEL THE PADGETT ” Practice Location

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