NPIMap

Organization Active NPI

Shandra Phillips

  • Behavior Technician
  • Gainesville, FL
National Provider Identifier
1053834341
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Legal business name
SHANDRA PHILLIPS
Practice address
205 SE 16TH Ave Apt 19C
Gainesville, FL 32601-8635
Phone
(352) 634-8068
NPI assigned
Jul 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Authorized official

Name
Ms. Shandra PhillipsNPI 1487353884
Title
Provider
Phone
(904) 505-4972

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X Primary
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

205 SE 16TH Ave Apt 19C
Gainesville, FL 32601-8635

Mailing address

814 SE 18TH Ter
Gainesville, FL 32641-9423
Phone (352) 278-7651

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1500422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555545600000",
    "number": "1053834341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 SE 18TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326419423",
            "telephone_number": "352-278-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SE 16TH AVE APT 19C",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326018635",
            "telephone_number": "352-634-8068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANDRA PHILLIPS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-19",
        "last_updated": "2019-04-18",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "SHANDRA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "904-505-4972",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; 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.