Active NPI
Kennedy Shontz, BCBA
- Behavior Analyst
- Naperville, IL
National Provider Identifier
1992192009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-15-18350
- Practice address
- 1260 Iroquois Ave
Suite 306
Naperville, IL 60563-1689 - Phone
- (630) 210-2357
- NPI assigned
- Apr 16, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-15-18350 | IL | Primary |
Addresses
Primary practice location
1260 Iroquois Ave
Suite 306
Naperville, IL 60563-1689
Mailing address
863 Benedetti Dr
Apt 101
Naperville, IL 60563-8932
Phone (815) 263-5918
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": "1429142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429142400000",
"number": "1992192009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "863 BENEDETTI DR",
"address_2": "APT 101",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605638932",
"telephone_number": "815-263-5918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 IROQUOIS AVE",
"address_2": "SUITE 306",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605631689",
"telephone_number": "630-210-2357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHONTZ",
"first_name": "KENNEDY",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-16",
"last_updated": "2015-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IL",
"license": "1-15-18350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.