Individual provider Active NPI

Shannon Marie Pendlay

  • Behavior Technician
  • Newton, IL
National Provider Identifier
1174458376
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-26-505714 Issued in IL
Practice address
900 Liberty Ave
Newton, IL 62448-1808
Phone
(618) 783-7529
NPI assigned
Jun 17, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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 RBT-26-505714 IL Primary

Addresses

Primary practice location

900 Liberty Ave
Newton, IL 62448-1808

Mailing address

605 S Van Buren St
Newton, IL 62448-1651
Phone (618) 783-7529

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": "1781654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1174458376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S VAN BUREN ST",
            "city": "NEWTON",
            "state": "IL",
            "postal_code": "624481651",
            "telephone_number": "618-783-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 LIBERTY AVE",
            "city": "NEWTON",
            "state": "IL",
            "postal_code": "624481808",
            "telephone_number": "618-783-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDLAY",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-06-17",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-26-505714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.