Individual provider Active NPI

Kaytlyn Paige Shadish, RBT

  • Behavior Technician
  • Wexford, PA
National Provider Identifier
1194569749
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-222726 Issued in IN
Practice address
2500 Brooktree Rd Ste 101
Wexford, PA 15090-9278
Phone
(412) 301-6204
NPI assigned
Jun 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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-22-222726 IN Primary

Addresses

Primary practice location

2500 Brooktree Rd Ste 101
Wexford, PA 15090-9278

Mailing address

504 Euclid Ave
Canonsburg, PA 15317-2044
Phone (724) 271-8416

Other names 1

  • Kaytlyn Paige Carter Former name

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

State licenses

LicenseStateTypeSpecialty
RBT-22-222726INMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Stepone Neurodiversity Services LLC CurrentSince Jun 23, 2024 Accepting new patients

Locations

2500 Brooktree Rd
Ste 101
Wexford, PA 15090
Phone (412) 301-6204

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1194569749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 EUCLID AVE",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153172044",
            "telephone_number": "724-271-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BROOKTREE RD STE 101",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909278",
            "telephone_number": "412-301-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADISH",
        "first_name": "KAYTLYN",
        "middle_name": "PAIGE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-22-222726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYTLYN",
            "last_name": "CARTER",
            "middle_name": "PAIGE",
            "credential": "RBT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wexford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.