Shades of Autism Parent Network, Inc.

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Legal business name

SHADES OF AUTISM PARENT NETWORK, INC.

Practice address

2736 University Blvd W Ste 5
Jacksonville, FL 32217-2170

Phone

(904) 209-4876

NPI assigned

Oct 19, 2021

Organization subpart

No

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

Authorized official

Name

Urrikka Bianca Woods-Scott

Title

Executive Director

Phone

(904) 209-4876

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1861155616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 ELISE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322114709",
            "telephone_number": "904-209-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2736 UNIVERSITY BLVD W STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172170",
            "telephone_number": "904-209-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADES OF AUTISM PARENT NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "WOODS-SCOTT",
        "authorized_official_first_name": "URRIKKA",
        "authorized_official_middle_name": "BIANCA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-209-4876"
    },
    "taxonomies": [
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittni Shackleford
• Lori Shad
• Rachael Morrow Shad, APRN
• Elizabeth Burty Shadden, LMHC
• Paige Shadden
• Michael Shaeffer, DMD
• Warren Shaeffer
• Willette Shaeffer, DMD
• William Shaeffer, DMD
• Winston Shaeffer, D.M.D.

• Child Intellectual and/or Developmental Disabilities Respite Care in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.