Individual provider Active NPI

Madeline Evans

  • Behavior Technician
  • South Ogden, UT
National Provider Identifier
1003498379
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
6033 Fashion Point Dr
South Ogden, UT 84403-4847
Phone
(605) 271-2690
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

6033 Fashion Point Dr
South Ogden, UT 84403-4847

Mailing address

6033 Fashion Point Dr
South Ogden, UT 84403-4847
Phone (605) 271-2690

Other practice location 1

12222 S 1000 E Ste 3
Draper, UT 84020-3203
Phone (801) 987-3592

Other practice location 2

1438 N Highway 89 Ste 130
Farmington, UT 84025-2737
Phone (605) 271-2690

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": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1003498379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 FASHION POINT DR",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034847",
            "telephone_number": "605-271-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6033 FASHION POINT DR",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034847",
            "telephone_number": "605-271-2690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12222 S 1000 E Ste 3",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840203203",
            "country_code": "US",
            "telephone_number": "801-987-3592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1438 N Highway 89 Ste 130",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "UT",
            "postal_code": "840252737",
            "country_code": "US",
            "telephone_number": "605-271-2690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MADELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ogden, UT

Sources for this page

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