Shirley Riddle, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-59402 Issued in FL

Practice address

2930 Loopdale Lane
Kissimmee, FL 34741-3436

Phone

(407) 308-5240

Fax

(407) 369-5488

NPI assigned

Jul 17, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Concordia ABA LLC

  • Behavior Analyst
  • Orlando, FL
  • NPI 1104771575
  NPD (past) Authorized official

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1558914788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 DERBY GLEN DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378029",
            "telephone_number": "407-318-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 LOOPDALE LANE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413436",
            "telephone_number": "407-308-5240",
            "fax_number": "407-369-5488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDDLE",
        "first_name": "SHIRLEY",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "1863994",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-22-59402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Richards, APRN
• Antia Richardson, MA, MS
• Elliott Richardson
• Ronda Richardson, R.PH
• Laura Holley Ricks
• Sylvia Riddle
• Kelsie Riebel, M.A., CCC-SLP
• Alexandra Yanira Rigaud, ARNP
• Right by You LLC
• Lauren Riley

• Behavior Analyst in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.