Active NPI
Shasnor Watson Sr.
- Behavior Technician
- Tavares, FL
National Provider Identifier
1821972290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB674148
- Practice address
- 3176 Bayou LN
Tavares, FL 32778-2060 - Phone
- (352) 800-1804
- NPI assigned
- Jul 31, 2025
- Last updated
- Jul 31, 2025
- Sex
- Male
- 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 Technician | 106S00000X | BACB674148 | FL | Primary |
Addresses
Primary practice location
3176 Bayou LN
Tavares, FL 32778-2060
Mailing address
3176 Bayou LN
Tavares, FL 32778-2060
Phone (352) 800-1804
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 |
|---|---|---|---|
| BACB674148 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1753920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753920000000",
"number": "1821972290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3176 BAYOU LN",
"city": "TAVARES",
"state": "FL",
"postal_code": "327782060",
"telephone_number": "352-800-1804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3176 BAYOU LN",
"city": "TAVARES",
"state": "FL",
"postal_code": "327782060",
"telephone_number": "352-800-1804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "SHASNOR",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-07-31",
"last_updated": "2025-07-31",
"certification_date": "2025-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "BACB674148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tavares, FL
- Waterman Anesthesiology Group PA
- Waterman SNF Operations LLC (Solaris Healthcare Waterman)
- Tamara C Watkins
- John Thomas Watson, M.D.
- Rohan M Watson, MD
- Melissa Kaitlyn Weaver
- William Henry Weaver, D.O.
- Victoria Denise Weeks Evans, BEHAVIOR ANALYST
- Samuel Clayton Weeks Jr., BEHAVIOR TECHNICIAN
- Scott Wehrly, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.