Active NPI
Ronniqua Cannon
- Behavior Technician
- Saint Louis, MO
National Provider Identifier
1003674342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-318947
- Practice address
- 3555 Sunset Office Dr
Saint Louis, MO 63127-1015 - Phone
- (314) 377-5968
- NPI assigned
- Mar 11, 2024
- 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-23-318947 | MO | Primary |
Addresses
Primary practice location
3555 Sunset Office Dr
Saint Louis, MO 63127-1015
Mailing address
5207 Lakewood Ter Apt 205
Imperial, MO 63052-4044
Phone (314) 405-0280
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-23-318947 | MO | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710115200000",
"number": "1003674342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5207 LAKEWOOD TER APT 205",
"city": "IMPERIAL",
"state": "MO",
"postal_code": "630524044",
"telephone_number": "314-405-0280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3555 SUNSET OFFICE DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631271015",
"telephone_number": "314-377-5968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANNON",
"first_name": "RONNIQUA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-11",
"last_updated": "2024-03-11",
"certification_date": "2024-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MO",
"license": "RBT-23-318947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.