MEDICARE: SHAVON CHAMPAGNE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1932690070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAVON CHAMPAGNE

Provider Business Mailing Address
First Line	:	2206 EXECUTIVE DR STE A
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-2583
Country	:	US
Telephone Number	:	757-664-9778
Fax Number	:

Provider Business Practice Location Address
First Line	:	2206 EXECUTIVE DR STE A
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-2583
Country	:	US
Telephone Number	:	757-664-9778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2018
Last Update Date	:	02/01/2026

Similar Medicare Providers

1902614001 — KATHARINE LEE GALLAGHER BCABA
Practice Location Address:

2206 EXECUTIVE DR STE A
HAMPTON, VA
23666-2583

Practice Phone: 757-664-9778
Practice Fax: 757-903-0114

1407856610 — DR. GEOFFREY BACON M.D.
Practice Location Address:

901 ENTERPRISE PARKWAY , SUITE 300
HAMPTON, VA
23666-2583

Practice Phone: 757-825-2500
Practice Fax: 757-825-2521

1538311501 — KEN J TOMPKINS MD PC
Practice Location Address:

2206 EXECUTIVE DR STE F
HAMPTON, VA
23666-2583

Practice Phone: 757-825-1846
Practice Fax: 757-825-1587

1265883995 — DIVINE HOME HEALTH CARE LLC
Practice Location Address:

2206 EXECUTIVE DR , SUITE A
HAMPTON, VA
23666-2583

Practice Phone: 757-224-7124
Practice Fax:

1235635442 — ARISA PHELPS RBT
Practice Location Address:

2206 EXECUTIVE DR STE A
HAMPTON, VA
23666-2583

Practice Phone: 757-664-9778
Practice Fax: 757-903-0114

1215434253 — STACY ANN HARRIS HERNANDEZ FNP-BC
Practice Location Address:

2206 EXECUTIVE DR STE F
HAMPTON, VA
23666-2583

Practice Phone: 757-825-1440
Practice Fax: 757-825-1587

Directions to “ SHAVON CHAMPAGNE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.