Individual provider Active NPI

Shelly A Rogin

  • Behavior Technician
  • Waterford, MI
National Provider Identifier
1295379980
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
140 Garland Way
Waterford, MI 48327-3687
Phone
(248) 520-6287
NPI assigned
Nov 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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 MI Primary

Addresses

Primary practice location

140 Garland Way
Waterford, MI 48327-3687

Mailing address

140 Garland Way
Waterford, MI 48327-3687
Phone (248) 520-6287

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": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1295379980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 GARLAND WAY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273687",
            "telephone_number": "248-520-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 GARLAND WAY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273687",
            "telephone_number": "248-520-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGIN",
        "first_name": "SHELLY",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.