Jeremiah Shawn Shultz

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

16941 N Eagle River Loop Rd
Eagle River, AK 99577-7824

Phone

(907) 726-5330

NPI assigned

Dec 16, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1093286155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 E 37TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16941 N EAGLE RIVER LOOP RD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777824",
            "telephone_number": "907-726-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "JEREMIAH",
        "middle_name": "SHAWN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Sheets
• Joseph Shepherd
• Jangmoo Sherpa
• Brittany Victoria Sholts, OTR/L
• Jessica Showalter
• Jaime L Simkins, LMT
• Cory Simpson
• Robert David Skala, DO
• Timothy W Skala, D.O.
• Jennifer Susan Skavhaug, M.A., LPC

• All providers in Eagle River, AK
• Behavior Technician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.