Active NPI
Carley J Sheppard, MS, BCBA
- Behavior Analyst
- Yulee, FL
National Provider Identifier
1750865317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-20-45847
- Practice address
- 464073 State Road 200
Yulee, FL 32097-6307 - Phone
- (800) 356-4049
- Fax
- (941) 485-0519
- NPI assigned
- Sep 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Behavior Technician | 106S00000X | RBT-18-65699 | NJ | |
| Behavior Analyst | 103K00000X | 1-20-45847 | FL | Primary |
Addresses
Primary practice location
464073 State Road 200
Yulee, FL 32097-6307
Mailing address
PO Box 631278, Oh
Cincinnati, OH 45263-0001
Phone (800) 356-4049
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-65699 | NJ | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682985600000",
"number": "1750865317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 631278, OH",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452630001",
"telephone_number": "800-356-4049",
"fax_number": "941-485-0519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "464073 STATE ROAD 200",
"city": "YULEE",
"state": "FL",
"postal_code": "320976307",
"telephone_number": "800-356-4049",
"fax_number": "941-485-0519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPPARD",
"first_name": "CARLEY",
"middle_name": "J",
"credential": "MS, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-19",
"last_updated": "2023-05-02",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NJ",
"license": "RBT-18-65699",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-20-45847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yulee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.