Individual provider Active NPI

Kery Montenegro

  • Behavior Technician
  • Miami Gardens, FL
National Provider Identifier
1003553728
Registry record updated May 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-210087 Issued in FL
Practice address
19177 NW 45TH Ave
Miami Gardens, FL 33055-2104
Phone
(786) 270-6823
NPI assigned
May 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 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 RBT-22-210087 FL Primary

Addresses

Primary practice location

19177 NW 45TH Ave
Miami Gardens, FL 33055-2104

Mailing address

19177 NW 45TH Ave
Miami Gardens, FL 33055-2104
Phone (786) 270-6823

Other identifiers 1

IdentifierTypeStateIssuer
M-535-503-74-906-0OtherFLDRIVER LICENCE

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

LicenseStateTypeSpecialty
RBT-22-210087FLMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652486400000",
    "number": "1003553728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19177 NW 45TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552104",
            "telephone_number": "786-270-6823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19177 NW 45TH AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330552104",
            "telephone_number": "786-270-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTENEGRO",
        "first_name": "KERY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-14",
        "last_updated": "2022-05-14",
        "certification_date": "2022-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-22-210087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENCE",
            "identifier": "M-535-503-74-906-0",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.