Active NPI
Theodore Nickolas Truby, RBT
- Behavior Technician
- Salt Lake City, UT
National Provider Identifier
1033675707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-18-73731
- Practice address
- 515 S 700 E
Salt Lake City, UT 84102-2801 - Phone
- (940) 923-6283
- NPI assigned
- Feb 18, 2019
- Sex
- Male
- Sole proprietor
- Yes
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-18-73731 | UT | Primary |
Addresses
Primary practice location
515 S 700 E
Salt Lake City, UT 84102-2801
Mailing address
1530 W Ponderosa LN
West Jordan, UT 84088-9241
Phone (940) 923-6283
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-18-73731 | UT | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550448000000",
"number": "1033675707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1530 W PONDEROSA LN",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840889241",
"telephone_number": "940-923-6283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 S 700 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841022801",
"telephone_number": "940-923-6283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRUBY",
"first_name": "THEODORE",
"middle_name": "NICKOLAS",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-18",
"last_updated": "2019-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "UT",
"license": "RBT-18-73731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.