Melanie C Shank

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0-12-4479

Practice address

740 E General Stewart Way Ste 103
Hinesville, GA 31313-2636

Phone

(877) 321-2899

Fax

(877) 540-0182

NPI assigned

Mar 7, 2012

Last updated

Mar 31, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Melanie C Koenig Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Refocus Behavior, LLC

  • Behavior Analyst
  • Hinesville, GA
  • NPI 1235762998
  NPD (past)

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1134493257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 OAK SIDE CT",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313245356",
            "telephone_number": "860-559-8854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 E GENERAL STEWART WAY STE 103",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313132636",
            "telephone_number": "877-321-2899",
            "fax_number": "877-540-0182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79 Olde Cottage Ln",
            "address_purpose": "LOCATION",
            "city": "Midway",
            "state": "GA",
            "postal_code": "313202307",
            "country_code": "US",
            "telephone_number": "860-559-8854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANK",
        "first_name": "MELANIE",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "0-12-4479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "KOENIG",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Serenity House PCH, Inc.
• Serenity House PCH, Inc.
• Serenity Rose
• Serve, LLC (DBA: Annette J Benneche)
• Daniel L Severtson, ATC
• Belinda Joy Sharp, MS, LMHC,LPC
• Rebecca Parker Shaver, PA-C
• Nathanial Shears
• Mahri Westphal Palmer Shelton, M.ED. BCBA
• James Adam Shuman, PTA

• Behavior Analyst in Hinesville, GA
• Providers in Hinesville, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.