Shannon Tatum

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

11661 Preston Rd Ste 260
Dallas, TX 75230-6108

Phone

(214) 440-7313

NPI assigned

Jun 17, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1871119610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD STE 260",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306108",
            "telephone_number": "214-440-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD STE 260",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752306108",
            "telephone_number": "214-440-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "behavioralinnovations.com",
            "affiliation": "Y",
            "endpointDescription": "website",
            "affiliationName": "Monarch Behavioral Therapy BII, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11661 Preston Rd Ste 260",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752306108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donna F Tatum-Green
• Adrianna Tatum
• Jordan Batson Tatum, OTR
• Kentoria Tatum
• Leslie Anne Tatum, MSCCCSLP
• Shermicka Tatum
• Tyra Tatum
• Larry R Taub, M.D.
• Daniel Tauber, MD
• Carl David Tauch, CPO

• Behavior Technician in Dallas, TX
• Providers in Dallas, TX by specialty
• Behavior Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.