Active NPI
Colleen Wilson, RBT
- Behavior Technician
- Shelbyville, IN
National Provider Identifier
1417531898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-133651
- Practice address
- 120 W Jackson St Ste B&C
Shelbyville, IN 46176-1295 - Phone
- (317) 512-2101
- NPI assigned
- May 11, 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 | RBT-20-133651 | IN | Primary |
Addresses
Primary practice location
120 W Jackson St Ste B&C
Shelbyville, IN 46176-1295
Mailing address
2871 N Talley Rd
Columbus, IN 47203-9169
Phone (812) 344-3885
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 |
|---|---|---|---|
| RBT-20-133651 | IN | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647475200000",
"number": "1417531898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2871 N TALLEY RD",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472039169",
"telephone_number": "812-344-3885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 W JACKSON ST STE B&C",
"city": "SHELBYVILLE",
"state": "IN",
"postal_code": "461761295",
"telephone_number": "317-512-2101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "COLLEEN",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-11",
"last_updated": "2022-03-17",
"certification_date": "2022-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT-20-133651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelbyville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.