Individual provider Active NPI

Shana Leigh Wiggins, B.A., BCABA

  • Behavior Analyst
  • Irving, TX
National Provider Identifier
1508009259
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0062149 Issued in TX
Practice address
400 E Royal LN Ste 290
Irving, TX 75039-3602
Phone
(855) 832-6727
Fax
(726) 759-1007
NPI assigned
Apr 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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 0062149 TX Primary

Addresses

Primary practice location

400 E Royal LN Ste 290
Irving, TX 75039-3602

Mailing address

303 W Nash St
Grapevine, TX 76051-5512
Phone (817) 424-9797

Other practice location 1

3301 N 3rd St
Abilene, TX 79603-7054
Phone (855) 832-6727

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
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
0062149TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Easter Seals North Texas Inc. Past Accepting new patients
Easter Seals North Texas Inc. Behavior Analyst Past Accepting new patients

Organizations & group practices 2

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": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1508009259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W NASH ST",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515512",
            "telephone_number": "817-424-9797",
            "fax_number": "817-424-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E ROYAL LN STE 290",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750393602",
            "telephone_number": "855-832-6727",
            "fax_number": "726-759-1007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 N 3rd St",
            "address_purpose": "LOCATION",
            "city": "Abilene",
            "state": "TX",
            "postal_code": "796037054",
            "country_code": "US",
            "telephone_number": "855-832-6727",
            "fax_number": "772-675-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "SHANA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "B.A., BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-10",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "0062149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.