Shape Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SHAPE CENTER

Practice address

326 N LBJ Dr Ste 198
San Marcos, TX 78666-5624

Phone

(323) 717-9568

NPI assigned

Dec 7, 2022

Last updated

Dec 7, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ninette Antoinette Threatt, MANPI 1740868215

Title

Bcba

Phone

(323) 717-9568

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ninette Threatt, MS, BCBA

  • Behavior Analyst
  • Los Angeles, CA
  • NPI 1740868215
  NPD Authorized official
• Kathryn Nicole Walpole

  • Behavior Analyst
  • San Marcos, TX
  • NPI 1619587730
  NPD (past)
• Kiana Rene Porter

  • Behavior Analyst
  • Long Beach, CA
  • NPI 1730650961
  NPD (past)

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1659082907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 N LBJ DR STE 198",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786665624",
            "telephone_number": "323-717-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 N LBJ DR STE 198",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786665624",
            "telephone_number": "323-717-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAPE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "THREATT",
        "authorized_official_first_name": "NINETTE",
        "authorized_official_middle_name": "ANTOINETTE",
        "authorized_official_title_or_position": "BCBA",
        "authorized_official_telephone_number": "323-717-9568",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Renee Severson, MSN, APRN, FNP-C
• Sarah Marie Severson, D.D.S.
• Randolph Cochrane Seybold, MD
• SH & LPB Holdings, LLC (Medpark Hearing Center)
• Kelsey Shaltry, RD, LD
• Murray H. Shapiro, M.D.
• Timothy J Shaw, M.D.
• Rebecca Shively
• Katherine Alison Sides, MD
• Nikki C Silva, CPNP-PC

• Community/Behavioral Health Agency in San Marcos, TX
• Providers in San Marcos, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.