Shining New Light LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SHINING NEW LIGHT LLC

Practice address

4050 E Greenway Rd Ste 4
Phoenix, AZ 85032-4700

Phone

(630) 900-7568

NPI assigned

Feb 11, 2022

Organization subpart

No

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

Authorized official

Name

Kandace WadlingtonNPI 1003573916

Title

Acting Chief Admin. Officer

Phone

(773) 600-3507

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kandace Wadlington

  • Behavior Technician
  • Phoenix, AZ
  • NPI 1003573916
  NPD Authorized official

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1558015115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 E GREENWAY RD STE 4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 E GREENWAY RD STE 4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324700",
            "telephone_number": "630-900-7568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINING NEW LIGHT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "WADLINGTON",
        "authorized_official_first_name": "KANDACE",
        "authorized_official_title_or_position": "ACTING CHIEF ADMIN. OFFICER",
        "authorized_official_telephone_number": "773-600-3507"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda L Shinar, M.D.
• Ron Z Shinar, MD
• Richard L. Shindell, M.D.
• Shine Dental Arts PLLC
• Peggy Shingleton
• Shiningstar Independent LLC
• Jessica Juleen Shinkle Williams
• Shelby Tate Shinn, RN
• Eliezer Shinnar
• Marlene Shiple, PH.D.

• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

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

Verify at the official NPI Registry.