Individual provider Active NPI

Taja Brothers, RBT

  • Behavior Technician
  • McDonough, GA
National Provider Identifier
1003400748
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
382 Racetrack Rd
McDonough, GA 30252-1022
Phone
(678) 691-2206
NPI assigned
Feb 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

382 Racetrack Rd
McDonough, GA 30252-1022

Mailing address

416 Camella Cir
McDonough, GA 30252-8918
Phone (678) 972-2476

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL taja_brothers@yahoo.com

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": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1003400748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 CAMELLA CIR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302528918",
            "telephone_number": "678-972-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 RACETRACK RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521022",
            "telephone_number": "678-691-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERS",
        "first_name": "TAJA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "taja_brothers@yahoo.com",
            "affiliation": "N",
            "address_1": "382 Racetrack Rd",
            "city": "McDonough",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302521022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.