Individual provider Active NPI

Shannon Kiehm

  • Behavior Analyst
  • Las Vegas, NV
National Provider Identifier
1831456748
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
CABI00009 Issued in NV
Practice address
2700 E Sunset Rd Ste 3
Las Vegas, NV 89120-3507
Phone
(702) 270-3219
NPI assigned
Apr 16, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X CABI00009 NV Primary

Addresses

Primary practice location

2700 E Sunset Rd Ste 3
Las Vegas, NV 89120-3507

Mailing address

4939 Droubay Dr
Las Vegas, NV 89122-8131
Phone (702) 545-5933

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

LicenseStateTypeSpecialty
CABI00009NVMDBehavioral Analyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1831456748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 DROUBAY DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891228131",
            "telephone_number": "702-545-5933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 E SUNSET RD STE 3",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203507",
            "telephone_number": "702-270-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIEHM",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-16",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NV",
            "license": "CABI00009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.