Active NPI
Kathryn Corinne Devane-Shelor
- Behavior Technician
- Wytheville, VA
National Provider Identifier
1356017453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 705 E Main St
Wytheville, VA 24382-3301 - Phone
- (276) 223-0672
- NPI assigned
- Aug 18, 2021
- 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 | VA | Primary |
Addresses
Primary practice location
705 E Main St
Wytheville, VA 24382-3301
Mailing address
705 E Main St
Wytheville, VA 24382-3301
Phone (276) 223-0672
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1818269 | Medicaid | VA |
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": "1629244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629244800000",
"number": "1356017453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 E MAIN ST",
"city": "WYTHEVILLE",
"state": "VA",
"postal_code": "243823301",
"telephone_number": "276-223-0672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 E MAIN ST",
"city": "WYTHEVILLE",
"state": "VA",
"postal_code": "243823301",
"telephone_number": "276-223-0672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVANE-SHELOR",
"first_name": "KATHRYN",
"middle_name": "CORINNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-18",
"last_updated": "2021-08-18",
"certification_date": "2021-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1818269",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wytheville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.