Shayne Ryan Beatty, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

3401 Colonial Dr
Columbia, SC 29203-6934

Phone

(803) 394-5619

Fax

(803) 339-1907

NPI assigned

Apr 1, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Bardin Behavioral Health, LLC

  • Behavior Analyst
  • Columbia, SC
  • NPI 1487160602
  NPD

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1467030163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036934",
            "telephone_number": "803-394-5619",
            "fax_number": "803-339-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 COLONIAL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036934",
            "telephone_number": "803-394-5619",
            "fax_number": "803-339-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATTY",
        "first_name": "SHAYNE",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DL#",
            "identifier": "102909247",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://bardinbehavioralhealth.com",
            "affiliation": "N",
            "address_1": "3401 Colonial Dr",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292036934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jasmine Denise Beasley
• Lauren Beasley, M.D.
• Paul F. Beattie, PHD,PT,OCS
• Dmarcus Jamall Beatty, R.T.
• Michelle Beatty, LISW-CP
• Beaty & Beaty, LLC
• Elizabeth Adelyn Beaty, MD
• Julia Faith Price Beaty, MSW, LISW-CP
• Robert H. Beaty Jr., BCBA
• Danielle Beaudoin

• All providers in Columbia, SC
• Behavior Technician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.

Verify at the official NPI Registry.