Individual provider Active NPI

Shona Flemming, RBT

  • Behavior Technician
  • Melbourne, FL
National Provider Identifier
1982056578
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
475 S John Rodes Blvd
Melbourne, FL 32904-1093
Phone
(775) 742-1912
Fax
(321) 765-6434
NPI assigned
Jul 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1621254 FL
Behavior Technician 106S00000X FL Primary

Addresses

Primary practice location

475 S John Rodes Blvd
Melbourne, FL 32904-1093

Mailing address

475 S John Rodes Blvd
Melbourne, FL 32904-1093
Phone (775) 742-1912

Other identifiers 1

IdentifierTypeStateIssuer
1621254OtherFLRBT

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

State licenses

LicenseStateTypeSpecialty
1621254FLMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
MK ABA, LLC Behavior Analyst Current Accepting new patients

Organizations & group practices 1

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": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982056578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 S JOHN RODES BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329041093",
            "telephone_number": "775-742-1912",
            "fax_number": "321-765-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 S JOHN RODES BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329041093",
            "telephone_number": "775-742-1912",
            "fax_number": "321-765-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMMING",
        "first_name": "SHONA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1621254",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBT",
            "identifier": "1621254",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.