Active NPI
Emily Alyssa Shannon, RBT
- Behavior Technician
- Oviedo, FL
National Provider Identifier
1851050223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 195283
- Practice address
- 1310 Oviedo Mall Blvd
Oviedo, FL 32765-7418 - Phone
- (605) 271-2690
- NPI assigned
- Dec 14, 2021
- 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 | 195283 | FL | Primary |
Addresses
Primary practice location
1310 Oviedo Mall Blvd
Oviedo, FL 32765-7418
Mailing address
1105 W Russell St
Sioux Falls, SD 57104-1322
Other practice location 1
3200 S Hiawassee Rd
Orlando, FL 32835-6317
Phone (407) 490-1453
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 |
|---|---|---|---|
| 195283 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camen Behavioral Services, LLC | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1851050223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 W RUSSELL ST",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571041322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 OVIEDO MALL BLVD",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327657418",
"telephone_number": "605-271-2690"
}
],
"practiceLocations": [
{
"address_1": "3200 S Hiawassee Rd",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328356317",
"country_code": "US",
"telephone_number": "407-490-1453",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHANNON",
"first_name": "EMILY",
"middle_name": "ALYSSA",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-14",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "195283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oviedo, FL
- Sentry Emergency Physicians, LLC
- Maritza Seoane, DDS
- Alokee Shah, PTA
- Manish Shah, RPH, M.S.
- Shereen Ann Shaikh, CCC-SLP
- Shaping Speech, LLC
- Sheridan Healthcorp Inc
- Sheridan Radiology Services of Central Florida, Inc.
- Sheridan Radiology Services of Central Florida, Inc.
- Sheridan Radiology Services of Pinellas, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.