Active NPI
Keyanna Johnson
- Behavior Technician
- Deltona, FL
National Provider Identifier
1003555756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 21165699
- Practice address
- 537 Deltona Blvd Ste 101
Deltona, FL 32725-8017 - Phone
- (914) 878-8683
- NPI assigned
- Jun 1, 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 | 21165699 | FL | Primary |
Addresses
Primary practice location
537 Deltona Blvd Ste 101
Deltona, FL 32725-8017
Mailing address
874 Orienta Ave Apt a
Altamonte Springs, FL 32701-5656
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 |
|---|---|---|---|
| 21165699 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654128000000",
"number": "1003555756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "874 ORIENTA AVE APT A",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327015656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "537 DELTONA BLVD STE 101",
"city": "DELTONA",
"state": "FL",
"postal_code": "327258017",
"telephone_number": "914-878-8683"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KEYANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-01",
"last_updated": "2022-06-02",
"certification_date": "2022-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "21165699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deltona, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.