Shannon Evelyn Blanks, M.S.ED., BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-30037

Practice address

1237 Augusta West Pkwy
Augusta, GA 30909-1807

Phone

(762) 685-4340

NPI assigned

Apr 25, 2018

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1710475751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL PKWY STE 200",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465028",
            "telephone_number": "407-915-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 AUGUSTA WEST PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091807",
            "telephone_number": "762-685-4340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4216 Washington Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "30809",
            "country_code": "US",
            "telephone_number": "762-222-7629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANKS",
        "first_name": "SHANNON",
        "middle_name": "EVELYN",
        "credential": "M.S.ED., BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-18-30037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Allen Blalock, M.D.
• Amy Renee Blanchard, MD
• Deborah S Blanchard, LPC
• Kaitlyn James Blanchard, MD
• Justinna Bland
• Christopher Olin Blanton, DDS
• Alvaro Blasi Beriain, D.D.S.
• Blake Blasingame
• Gregory Steven Blaufuss, MD
• Donna Lee Bledsoe, APRN, BC

• Behavior Analyst in Augusta, GA
• Providers in Augusta, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.