Robert Shine

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

109 E Merrill Ave
Fond Du Lac, WI 54935-3553

Phone

(920) 929-2820

NPI assigned

Oct 3, 2026

Last updated

Oct 3, 2026By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1790985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790985600000",
    "number": "1730083858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E MERRILL AVE",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353553",
            "telephone_number": "920-929-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E MERRILL AVE",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353553",
            "telephone_number": "920-929-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINE",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-03",
        "last_updated": "2026-10-03",
        "certification_date": "2026-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Fond Du Lac, WI
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.