Active NPI
Shanice Derby
- Behavior Analyst
- Bronx, NY
National Provider Identifier
1821730771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 4146 Baychester Ave
Bronx, NY 10466-2122 - Phone
- (646) 627-4326
- NPI assigned
- Apr 11, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
4146 Baychester Ave
Bronx, NY 10466-2122
Mailing address
4146 Baychester Ave
Bronx, NY 10466-2122
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043017 | Medicaid | NY |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Sunshinederby@aol.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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649635200000",
"number": "1821730771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4146 BAYCHESTER AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104662122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4146 BAYCHESTER AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104662122",
"telephone_number": "646-627-4326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERBY",
"first_name": "SHANICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-11",
"last_updated": "2022-04-11",
"certification_date": "2022-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "043017",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Sunshinederby@aol.com",
"affiliation": "N",
"address_1": "4146 Baychester Ave",
"city": "Bronx",
"state": "NY",
"country_code": "US",
"postal_code": "104662122",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.