Individual provider Active NPI

Shannon Mary Smiga

  • Behavior Technician
  • Springfield, VA
National Provider Identifier
1124686712
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5907 Noblestown Rd Apt G
Springfield, VA 22152-1108
Phone
(703) 967-3703
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X VA Primary

Addresses

Primary practice location

5907 Noblestown Rd Apt G
Springfield, VA 22152-1108

Mailing address

5907 Noblestown Rd Apt G
Springfield, VA 22152-1108
Phone (703) 967-3703

Other identifiers 1

IdentifierTypeStateIssuer
926997072OtherVAUNITED HEALTHCARE

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": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1124686712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5907 NOBLESTOWN RD APT G",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521108",
            "telephone_number": "703-967-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5907 NOBLESTOWN RD APT G",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521108",
            "telephone_number": "703-967-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIGA",
        "first_name": "SHANNON",
        "middle_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "926997072",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.