Individual provider Active NPI

Shalyn N Copas, BCBA

  • Behavior Analyst
  • Poplar Bluff, MO
National Provider Identifier
1669032371
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-18-31725 Issued in MO
Practice address
1109 N 11TH St
Poplar Bluff, MO 63901-3732
Phone
(573) 872-7453
NPI assigned
Jun 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-18-31725 MO Primary

Addresses

Primary practice location

1109 N 11TH St
Poplar Bluff, MO 63901-3732

Mailing address

1109 N 11TH St
Poplar Bluff, MO 63901-3732
Phone (573) 872-7453

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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1669032371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 N 11TH ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013732",
            "telephone_number": "573-872-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 N 11TH ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013732",
            "telephone_number": "573-872-7453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPAS",
        "first_name": "SHALYN",
        "middle_name": "N",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "1-18-31725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.