Individual provider Active NPI

Shanna Bowden

  • Behavior Analyst
  • Fort Walton Beach, FL
National Provider Identifier
1316397698
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
419 Racetrack Rd NW
Fort Walton Beach, FL 32547-4612
Phone
(850) 862-3728
NPI assigned
Jun 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

419 Racetrack Rd NW
Fort Walton Beach, FL 32547-4612

Mailing address

419 Racetrack Rd NW
Fort Walton Beach, FL 32547-4612
Phone (850) 862-3728

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": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1316397698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 RACETRACK RD NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325474612",
            "telephone_number": "850-862-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 RACETRACK RD NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325474612",
            "telephone_number": "850-862-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWDEN",
        "first_name": "SHANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.