Active NPI
Adam Shelp
- Behavior Technician
- Canton, GA
National Provider Identifier
1811520679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-112818
- Practice address
- 12875 Cumming Hwy # 4
Canton, GA 30115-4884 - Phone
- (770) 240-0163
- NPI assigned
- Feb 19, 2020
- Sex
- Male
- 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 | RBT-20-112818 | GA | Primary |
Addresses
Primary practice location
12875 Cumming Hwy # 4
Canton, GA 30115-4884
Mailing address
5850 Crest Oak Way
Cumming, GA 30028-4018
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ashelp@joytlc.com |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-20-112818 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582070400000",
"number": "1811520679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5850 CREST OAK WAY",
"city": "CUMMING",
"state": "GA",
"postal_code": "300284018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12875 CUMMING HWY # 4",
"city": "CANTON",
"state": "GA",
"postal_code": "301154884",
"telephone_number": "770-240-0163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELP",
"first_name": "ADAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-19",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-20-112818",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ashelp@joytlc.com",
"affiliation": "N",
"address_1": "12875 Cumming Hwy # 4",
"city": "Canton",
"state": "GA",
"country_code": "US",
"postal_code": "301154884",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.