Active NPI
Summer Dyane Boyanton
- Behavior Technician
- Buchanan, GA
National Provider Identifier
1043062490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-21-154011
- Practice address
- 84 Lee Rd
Buchanan, GA 30113-2806 - Phone
- (678) 381-5221
- NPI assigned
- Apr 1, 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-21-154011 | GA | Primary |
Addresses
Primary practice location
84 Lee Rd
Buchanan, GA 30113-2806
Mailing address
84 Lee Rd
Buchanan, GA 30113-2806
Phone (678) 381-5221
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-21-154011 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1043062490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 LEE RD",
"city": "BUCHANAN",
"state": "GA",
"postal_code": "301132806",
"telephone_number": "678-381-5221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 LEE RD",
"city": "BUCHANAN",
"state": "GA",
"postal_code": "301132806",
"telephone_number": "678-381-5221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYANTON",
"first_name": "SUMMER",
"middle_name": "DYANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-01",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-21-154011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buchanan, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.