Individual provider Active NPI

Shelby Holtson, MA, BCBA

  • Behavior Analyst
  • Bloomington, IN
National Provider Identifier
1326645425
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-58191
Practice address
1501 W Tapp Rd
Bloomington, IN 47403-3459
Phone
(812) 330-4460
NPI assigned
Oct 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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 1-22-58191 Primary

Addresses

Primary practice location

1501 W Tapp Rd
Bloomington, IN 47403-3459

Mailing address

1923 S Liberty Dr
Bloomington, IN 47403-5146
Phone (812) 330-4460

Other practice location 1

1923 S Liberty Dr
Bloomington, IN 47403-5146
Phone (812) 330-4460

Other practice location 2

900 Tutor Ln Ste 107
Evansville, IN 47715-7295
Phone (812) 602-1038

Other practice location 3

556 S Washington Street
Dale, IN 47523
Phone (812) 602-1038

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
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Reach High Consulting and Therapy, LLC Behavior Analyst PastSince Feb 12, 2023 Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1326645425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 S LIBERTY DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035146",
            "telephone_number": "812-330-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W TAPP RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474033459",
            "telephone_number": "812-330-4460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1923 S Liberty Dr",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474035146",
            "country_code": "US",
            "telephone_number": "812-330-4460",
            "fax_number": "812-330-4461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Tutor Ln Ste 107",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477157295",
            "country_code": "US",
            "telephone_number": "812-602-1038",
            "fax_number": "812-602-1048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "556 S Washington Street",
            "address_purpose": "LOCATION",
            "city": "Dale",
            "state": "IN",
            "postal_code": "47523",
            "country_code": "US",
            "telephone_number": "812-602-1038",
            "fax_number": "812-602-1048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLTSON",
        "first_name": "SHELBY",
        "credential": "MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2024-11-04",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-22-58191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.