Active NPI
Kurtis Shrewsberry, BCBA
- Behavior Analyst
- Naples, FL
National Provider Identifier
1508107350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-16-22007
- Practice address
- 3361 Pine Ridge Rd Ste 105
Naples, FL 34109-3937 - Phone
- (239) 254-4260
- Fax
- (239) 254-4261
- NPI assigned
- Mar 4, 2013
- Sex
- Male
- 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 Analyst | 103K00000X | 1-16-22007 | FL | Primary |
Addresses
Primary practice location
3361 Pine Ridge Rd Ste 105
Naples, FL 34109-3937
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 254-4260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017559000 | Medicaid | FL |
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": "1362355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1508107350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-254-4260",
"fax_number": "239-254-4261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3361 PINE RIDGE RD STE 105",
"city": "NAPLES",
"state": "FL",
"postal_code": "341093937",
"telephone_number": "239-254-4260",
"fax_number": "239-254-4261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHREWSBERRY",
"first_name": "KURTIS",
"name_prefix": "Mr.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-03-04",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-16-22007",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "017559000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.