Shardae Madison, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

21151047 Issued in FL

Practice address

1240 S Nova Rd Apt 119
Daytona Beach, FL 32114-5886

Phone

(248) 935-8231

NPI assigned

Oct 15, 2021

Last updated

Oct 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1629731740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 S NOVA RD APT 119",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145886",
            "telephone_number": "248-935-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 S NOVA RD APT 119",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321145886",
            "telephone_number": "248-935-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADISON",
        "first_name": "SHARDAE",
        "name_prefix": "Ms.",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "21151047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy F. Macnichol, ANP-C
• Tyree J Macon
• Lisa Macri, ARNP
• Jenayia Maddox
• Katarzyna I. Madejczyk, MD
• Samantha Maffucci, OT
• Magenta BP LLC
• Marcus Magidow, APRN
• Magnola Manor at Daytona Beach, LLC
• Hannah Neve Magnuson, APRN

• Behavior Technician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.