Active NPI
Shannon H Pua Jr.
- Behavior Technician
- Denver, CO
National Provider Identifier
1083440416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 8354 E Northfield Blvd Unit 3700
Denver, CO 80238-3135 - Phone
- (480) 698-2606
- NPI assigned
- Sep 11, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | AZ | Primary |
Addresses
Primary practice location
8354 E Northfield Blvd Unit 3700
Denver, CO 80238-3135
Mailing address
1960 W Keating Ave Apt 643
Mesa, AZ 85202-7083
Phone (480) 698-2606
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726012800000",
"number": "1083440416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1960 W KEATING AVE APT 643",
"city": "MESA",
"state": "AZ",
"postal_code": "852027083",
"telephone_number": "480-698-2606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8354 E NORTHFIELD BLVD UNIT 3700",
"city": "DENVER",
"state": "CO",
"postal_code": "802383135",
"telephone_number": "480-698-2606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUA",
"first_name": "SHANNON",
"middle_name": "H",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-11",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "AZ",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.