Individual provider Active NPI

Shaquille Innocent, RBT

  • Behavior Technician
  • Katy, TX
National Provider Identifier
1619769908
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1844 Snake River Rd Ste D
Katy, TX 77449-7757
Phone
(605) 271-2690
NPI assigned
May 21, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X TX Primary

Addresses

Primary practice location

1844 Snake River Rd Ste D
Katy, TX 77449-7757

Mailing address

1105 W Russell St
Sioux Falls, SD 57104-1322

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": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1619769908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 W RUSSELL ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571041322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1844 SNAKE RIVER RD STE D",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774497757",
            "telephone_number": "605-271-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INNOCENT",
        "first_name": "SHAQUILLE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; 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.