Shannon Wilson, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-50676

Practice address

1146 Dogwood Ave
Tampa, FL 33613-1718

Phone

(813) 418-0528

NPI assigned

Apr 24, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sunshine Behavior Partners LLC

  • Behavior Analyst
  • Tampa, FL
  • NPI 1508670811
  NPD Authorized official

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1003304171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4809 EHRLICH RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 DOGWOOD AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131718",
            "telephone_number": "813-418-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHANNON",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": "01910399",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-21-50676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rick Wilson, PT
• Rita Maria Wilson, A.R.N.P.
• Robert G Wilson, D.O.
• Samanta Wilson, APRN
• Sandy Denise Wilson, DNP-C
• Simon Arn Wilson, MD
• Skylar Wilson, MD
• Tanner Wilson
• Taylor Constance Wilson
• Todd Christopher Wilson

• Behavior Analyst in Tampa, FL
• Providers in Tampa, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.