Active NPI
Samuel Douglas Weber
- Behavior Technician
- Tucson, AZ
National Provider Identifier
1003575366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-21-194304
- Practice address
- 2230 E Prince Rd
Tucson, AZ 85719-2002 - Phone
- (520) 461-7550
- NPI assigned
- Dec 14, 2021
- Sex
- Male
- 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-21-194304 | AZ | Primary |
Addresses
Primary practice location
2230 E Prince Rd
Tucson, AZ 85719-2002
Mailing address
720 S 5TH Ave Apt 10
Tucson, AZ 85701-2753
Phone (414) 217-8560
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-21-194304 | AZ | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1003575366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 S 5TH AVE APT 10",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857012753",
"telephone_number": "414-217-8560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2230 E PRINCE RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857192002",
"telephone_number": "520-461-7550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEBER",
"first_name": "SAMUEL",
"middle_name": "DOUGLAS",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-12-14",
"last_updated": "2021-12-14",
"certification_date": "2021-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "AZ",
"license": "RBT-21-194304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.