Active NPI
Samantha Elisabeth Sutton
- Behavior Technician
- Lutz, FL
National Provider Identifier
1003523184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-241917
- Practice address
- 17774 Swordfish Dr Apt G
Lutz, FL 33558-6088 - Phone
- (217) 691-5940
- NPI assigned
- Oct 31, 2022
- Sex
- Female
- 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 Technician | 106S00000X | RBT-22-241917 | FL | Primary |
Addresses
Primary practice location
17774 Swordfish Dr Apt G
Lutz, FL 33558-6088
Mailing address
17774 Swordfish Dr Apt G
Lutz, FL 33558-6088
Phone (217) 691-5940
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BNT822641817 | Other | IL | BCBS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-241917 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667174400000",
"number": "1003523184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17774 SWORDFISH DR APT G",
"city": "LUTZ",
"state": "FL",
"postal_code": "335586088",
"telephone_number": "217-691-5940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17774 SWORDFISH DR APT G",
"city": "LUTZ",
"state": "FL",
"postal_code": "335586088",
"telephone_number": "217-691-5940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTTON",
"first_name": "SAMANTHA",
"middle_name": "ELISABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-31",
"last_updated": "2022-10-31",
"certification_date": "2022-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-22-241917",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "BNT822641817",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lutz, FL
- Sunshine Primary Care LLC
- Support Associates of Tampa Bay, Inc
- Supported Employment and Living Facilitators, Inc. (SELF, Inc.)
- Neil Hans Surti, M.D.
- Subatha Suthakaran
- Tyler-Lawrence E Sutton
- Helena Svanstrom, P.T
- Sweet Dreams Tampa Sleep Apnea Institute LLC
- Synapse Healthcare LLC
- Synergic Healthcare Solutions LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.