Individual provider Active NPI

Shane Manion

  • Behavior Analyst
  • St Petersburg, FL
National Provider Identifier
1962964585
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
10901 Roosevelt Blvd N Ste 100
St Petersburg, FL 33716-2305
Phone
(888) 754-0398
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

10901 Roosevelt Blvd N Ste 100
St Petersburg, FL 33716-2305

Mailing address

6416 NW 5TH Way
Fort Lauderdale, FL 33309-6112
Phone (888) 754-0398

Other practice location 1

5447 E Beaumont Center Blvd
Tampa, FL 33634-5210
Phone (888) 754-0398

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vocational Development Group, LLC Behavior Analyst CurrentSince Aug 28, 2021 Accepting new patients
Vocational Development Group, LLC Behavior Analyst PastSince Aug 1, 2021 Accepting new patients
Vocational Development Group, LLC Behavior Analyst PastSince Aug 1, 2021 Accepting new patients
Vocational Development Group, LLC Behavior Analyst PastSince Sep 1, 2020 Accepting new patients
Vocational Development Group, LLC Behavior Analyst PastSince Aug 1, 2021 Accepting new patients

Locations

6416 NW 5th Way
Lauderdale Lakes, FL 33309
Phone (407) 489-2906

6973 University Blvd
Winter Park, FL 32792
Phone (407) 965-1960

Organizations & group practices 5

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1962964585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6416 NW 5TH WAY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333096112",
            "telephone_number": "888-754-0398",
            "fax_number": "954-982-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10901 ROOSEVELT BLVD N STE 100",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337162305",
            "telephone_number": "888-754-0398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5447 E Beaumont Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336345210",
            "country_code": "US",
            "telephone_number": "888-754-0398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANION",
        "first_name": "SHANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2024-03-04",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.

Verify at the official NPI Registry.