Individual provider Active NPI

Shanel Blackson

  • Behavior Technician
  • N Las Vegas, NV
National Provider Identifier
1194265017
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
4142 Consensus CT
N Las Vegas, NV 89032-6114
Phone
(702) 285-9892
NPI assigned
Feb 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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 NV Primary

Addresses

Primary practice location

4142 Consensus CT
N Las Vegas, NV 89032-6114

Mailing address

4142 Consensus CT
N Las Vegas, NV 89032-6114
Phone (702) 285-9892

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": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1194265017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4142 CONSENSUS CT",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890326114",
            "telephone_number": "702-285-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4142 CONSENSUS CT",
            "city": "N LAS VEGAS",
            "state": "NV",
            "postal_code": "890326114",
            "telephone_number": "702-285-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSON",
        "first_name": "SHANEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in N Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.