Individual provider Active NPI

Angelica Santos

  • Behavior Technician
  • Huntersville, NC
National Provider Identifier
1043861990
Registry record updated Sep 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-19-98674 Issued in NC
Practice address
9800 Kincey Ave Ste 160
Huntersville, NC 28078-8402
Phone
(980) 785-1113
Fax
(980) 785-1114
NPI assigned
Sep 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2019

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 RBT-19-98674 NC Primary

Addresses

Primary practice location

9800 Kincey Ave Ste 160
Huntersville, NC 28078-8402

Mailing address

814 Tyvola Rd Ste 126
Charlotte, NC 28217-3539
Phone (980) 785-1113

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

LicenseStateTypeSpecialty
RBT-19-98674NCMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Group, LLC PastSince Sep 29, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1043861990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 TYVOLA RD STE 126",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173539",
            "telephone_number": "980-785-1113",
            "fax_number": "980-785-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 KINCEY AVE STE 160",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280788402",
            "telephone_number": "980-785-1113",
            "fax_number": "980-785-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS",
        "first_name": "ANGELICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": "RBT-19-98674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.

Verify at the official NPI Registry.