Individual provider Active NPI

Shelby Taylor Gottula

  • Behavior Technician
  • Bentonville, AR
National Provider Identifier
1366309189
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2307 SE B St Ste 1
Bentonville, AR 72712-5314
Phone
(479) 802-4798
NPI assigned
Jan 5, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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 AR Primary

Addresses

Primary practice location

2307 SE B St Ste 1
Bentonville, AR 72712-5314

Mailing address

4000 S Dixieland Rd Apt B302
Rogers, AR 72758-0027
Phone (479) 269-1814

Other names 1

  • Edwin Taylor Gottula Other name

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": "1767571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768435200000",
    "number": "1366309189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 S DIXIELAND RD APT B302",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727580027",
            "telephone_number": "479-269-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 SE B ST STE 1",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727125314",
            "telephone_number": "479-802-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTULA",
        "first_name": "SHELBY",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWIN",
            "last_name": "GOTTULA",
            "middle_name": "TAYLOR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.