Individual provider Active NPI

Mary Ellen Fields

  • Behavior Technician
  • Smyrna, TN
National Provider Identifier
1043024912
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
883 Seven Oaks Blvd Ste 850
Smyrna, TN 37167-6691
Phone
(629) 216-2007
NPI assigned
Feb 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

883 Seven Oaks Blvd Ste 850
Smyrna, TN 37167-6691

Mailing address

300 International Pkwy Ste 300
Lake Mary, FL 32746-5000
Phone (629) 216-2007

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1043024912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 INTERNATIONAL PKWY STE 300",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465000",
            "telephone_number": "629-216-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 SEVEN OAKS BLVD STE 850",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676691",
            "telephone_number": "629-216-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.