Active NPI
Shawna Marie Wells, RBT
- Behavior Technician
- Orlando, FL
National Provider Identifier
1578073003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 500 E Colonial Dr
Orlando, FL 32803-4504 - Phone
- (407) 218-4340
- Fax
- (407) 218-4303
- NPI assigned
- Oct 11, 2017
- Sex
- Female
- 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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
500 E Colonial Dr
Orlando, FL 32803-4504
Mailing address
149 Gulf Circle North
Daytona Beach, FL 32119
Phone (501) 358-1569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019697600 | 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": "1507680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597017600000",
"number": "1578073003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 GULF CIRCLE NORTH",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "32119",
"telephone_number": "501-358-1569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E COLONIAL DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328034504",
"telephone_number": "407-218-4340",
"fax_number": "407-218-4303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "SHAWNA",
"middle_name": "MARIE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-11",
"last_updated": "2020-08-10",
"certification_date": "2020-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019697600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.