Active NPI
Themiah Shafaye Kendrick
- Behavior Technician
- Bainbridge, GA
National Provider Identifier
1730098021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 060481582
- Practice address
- 1405 Avenue a Apt 7
Bainbridge, GA 39819-1125 - Phone
- (229) 205-3122
- NPI assigned
- Sep 3, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 060481582 | GA | Primary |
Addresses
Primary practice location
1405 Avenue a Apt 7
Bainbridge, GA 39819-1125
Mailing address
1405 Ave a
#7
Bainbridge, GA 39819
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1730098021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 AVE A",
"address_2": "#7",
"city": "BAINBRIDGE",
"state": "GA",
"postal_code": "39819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 AVENUE A APT 7",
"city": "BAINBRIDGE",
"state": "GA",
"postal_code": "398191125",
"telephone_number": "229-205-3122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDRICK",
"first_name": "THEMIAH",
"middle_name": "SHAFAYE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-03",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "060481582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bainbridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.