Shannon Gibson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-111606 Issued in FL

Practice address

140 S Beach St Ste 310
Daytona Beach, FL 32114-4409

Phone

(386) 872-4892

Fax

(386) 256-2320

NPI assigned

Feb 6, 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1972135135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 S BEACH ST STE 310",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144409",
            "telephone_number": "386-872-4892",
            "fax_number": "386-256-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S BEACH ST STE 310",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144409",
            "telephone_number": "386-872-4892",
            "fax_number": "386-256-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-111606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD CERTIFICATION",
            "identifier": "RBT-20-111606",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.thehopegroup4.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "140 S Beach St Ste 310",
            "city": "Daytona Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321144409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James E Gibbs, MD
• Brenna Giblock
• Dana Marie Giblock, LCSW
• Courtney Gibson
• Rosie P Gibson
• Ometries D Giddens, CNA
• Michelle M Giddings, BCABA
• Jessika Gil-Pineda, MD
• Albert W. Gillespy, MD
• Lauren Michelle Gillespy, PA-C

• Behavior Technician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.