Active NPI
Shaquilla U Terry
- Behavior Technician
- Lowell, MA
National Provider Identifier
1831656131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 810 Broadway St, Apt 5
Lowell, MA 01854 - Phone
- (617) 756-9733
- NPI assigned
- Feb 23, 2019
- Sex
- Female
- 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 | MA | Primary |
Addresses
Primary practice location
810 Broadway St, Apt 5
Lowell, MA 01854
Mailing address
810 Broadway St, Apt 5
Lowell, MA 01854
Phone (617) 756-9733
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106S00000X | Other | KEY AUTISM | |
| 0 | Other | KEY AUTISM |
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": "1550880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560211200000",
"number": "1831656131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 BROADWAY ST, APT 5",
"city": "LOWELL",
"state": "MA",
"postal_code": "01854",
"telephone_number": "617-756-9733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 BROADWAY ST, APT 5",
"city": "LOWELL",
"state": "MA",
"postal_code": "01854",
"telephone_number": "617-756-9733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERRY",
"first_name": "SHAQUILLA",
"middle_name": "U",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-23",
"last_updated": "2019-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEY AUTISM",
"identifier": "106S00000X",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lowell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.