Active NPI
Kaytlyn Paige Shadish, RBT
- Behavior Technician
- Wexford, PA
National Provider Identifier
1194569749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-222726
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-222726 | IN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stepone Neurodiversity Services LLC | Current | 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.
-
- Behavior Analyst
- Wexford, PA
- NPI 1144954611
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.