Active NPI
Shanica Agenord
- Behavior Technician
- Sunrise, FL
National Provider Identifier
1093422115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 13650 NW 8TH St
Sunrise, FL 33325-6277 - Phone
- (888) 754-0398
- NPI assigned
- Oct 28, 2022
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
13650 NW 8TH St
Sunrise, FL 33325-6277
Mailing address
2064 NE 6TH St
Boynton Beach, FL 33435-3520
Phone (954) 955-1561
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | s.agenord@inbloomautism.com |
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": "1666915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666915200000",
"number": "1093422115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2064 NE 6TH ST",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334353520",
"telephone_number": "954-955-1561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13650 NW 8TH ST",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333256277",
"telephone_number": "888-754-0398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGENORD",
"first_name": "SHANICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-28",
"last_updated": "2022-10-28",
"certification_date": "2022-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "s.agenord@inbloomautism.com",
"affiliation": "N",
"address_1": "13650 NW 8th St",
"city": "Sunrise",
"state": "FL",
"country_code": "US",
"postal_code": "333256277",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.