Active NPI
Shaun Simpson
- Behavior Technician
- Stockbridge, GA
National Provider Identifier
1275214033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-263767
- Practice address
- 285 Country Club Dr Ste 300
Stockbridge, GA 30281-7355 - Phone
- (470) 944-1025
- NPI assigned
- Jul 26, 2023
- 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-23-263767 | GA | Primary |
Addresses
Primary practice location
285 Country Club Dr Ste 300
Stockbridge, GA 30281-7355
Mailing address
701 Carver Rd Apt G36
Griffin, GA 30224-8447
Phone (678) 469-9349
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-23-263767 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690329600000",
"number": "1275214033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 CARVER RD APT G36",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302248447",
"telephone_number": "678-469-9349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 COUNTRY CLUB DR STE 300",
"city": "STOCKBRIDGE",
"state": "GA",
"postal_code": "302817355",
"telephone_number": "470-944-1025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMPSON",
"first_name": "SHAUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-26",
"last_updated": "2023-07-26",
"certification_date": "2023-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-23-263767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockbridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.