Active NPI
Johnny Lee Shaffer
- Behavior Analyst
- Du Bois, PA
National Provider Identifier
1295389997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BH001561
- Practice address
- 25 E Park Ave
Du Bois, PA 15801-2271 - Phone
- (814) 279-4823
- NPI assigned
- Jul 31, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 Analyst | 103K00000X | BH001561 | PA | Primary |
Addresses
Primary practice location
25 E Park Ave
Du Bois, PA 15801-2271
Mailing address
25 E Park Ave
Du Bois, PA 15801-2271
Phone (814) 279-4823
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Merakey | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| BH001561 | PA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564531200000",
"number": "1295389997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 E PARK AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158012271",
"telephone_number": "814-279-4823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 E PARK AVE",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158012271",
"telephone_number": "814-279-4823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAFFER",
"first_name": "JOHNNY",
"middle_name": "LEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-31",
"last_updated": "2019-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "BH001561",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Merakey",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "25 E Park Ave",
"city": "Du Bois",
"state": "PA",
"country_code": "US",
"postal_code": "158012271",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Du Bois, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.