Active NPI
Nelly Berenice Wade, RBT
- Behavior Technician
- Amarillo, TX
National Provider Identifier
1033756945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-79966
- Practice address
- 6031 Bell St
Amarillo, TX 79109-6618 - Phone
- (806) 567-5845
- Fax
- (806) 500-2772
- NPI assigned
- Dec 10, 2019
- 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-19-79966 | TX | Primary |
Addresses
Primary practice location
6031 Bell St
Amarillo, TX 79109-6618
Mailing address
2414 6TH Ave Apt B
Canyon, TX 79015-4190
Phone (832) 489-8852
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-19-79966 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575936000000",
"number": "1033756945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2414 6TH AVE APT B",
"city": "CANYON",
"state": "TX",
"postal_code": "790154190",
"telephone_number": "832-489-8852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6031 BELL ST",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791096618",
"telephone_number": "806-567-5845",
"fax_number": "806-500-2772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "NELLY",
"middle_name": "BERENICE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-10",
"last_updated": "2019-12-10",
"certification_date": "2019-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "RBT-19-79966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.