Individual provider Active NPI

Shenika Bunn Wynn

  • Behavior Analyst
  • Las Vegas, NV
National Provider Identifier
1902227226
Registry record updated Jan 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1000 Dumont Blvd
208
Las Vegas, NV 89169-4264
Phone
(702) 467-7424
NPI assigned
Jan 5, 2014
Last updated
Jan 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Behavior Analyst 103K00000X Primary
Cognitive & Behavioral Psychologist 103TB0200X

Addresses

Primary practice location

1000 Dumont Blvd
208
Las Vegas, NV 89169-4264

Mailing address

1000 Dumont Blvd
208
Las Vegas, NV 89169-4264
Phone (702) 467-7424

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": "1388880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388880000000",
    "number": "1902227226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 DUMONT BLVD",
            "address_2": "208",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891694264",
            "telephone_number": "702-467-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 DUMONT BLVD",
            "address_2": "208",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891694264",
            "telephone_number": "702-467-7424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNN WYNN",
        "first_name": "SHENIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-05",
        "last_updated": "2014-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jan 5, 2014; 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.