Shelby Jean Bournival

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-26-2828235 Issued in FL

Practice address

2859 S Bumby Ave
Orlando, FL 32806-8704

Phone

(407) 800-7711

NPI assigned

Feb 10, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Hidden Potential Florida LLC

  • Behavior Analyst
  • Orlando, FL
  • NPI 1508404211
  NPD (past)

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

{
    "created_epoch": "1675987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1912604844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2859 S BUMBY AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328068704",
            "telephone_number": "407-800-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2859 S BUMBY AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328068704",
            "telephone_number": "407-800-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNIVAL",
        "first_name": "SHELBY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-10",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-26-2828235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bettina Bourda, OTR/L, CLT
• Virginia Milagros Bouret
• Anissa Lynn Bourgeacq, RDN
• Bourillon Solutions LLC
• Anthony Bourne
• Miriadel Juleve Boursiquot
• Charbel Boustany
• Susan Lyn Boutcher, CCC-SLP
• Alexis Joan Boutchie, CAA
• Jennifer Michelle Boutin, RD, LDN

• Behavior Analyst in Orlando, FL
• Providers in Orlando, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.