Active NPI
Andrew Charles Carter, RBT
- Behavior Technician
- Stuart, FL
National Provider Identifier
1073138178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- C636003930510
- Practice address
- 7108 S Kanner Hwy
Stuart, FL 34997-7462 - Phone
- (855) 832-6722
- NPI assigned
- Jun 15, 2020
- 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 | C636003930510 | FL | Primary |
Addresses
Primary practice location
7108 S Kanner Hwy
Stuart, FL 34997-7462
Mailing address
2064 Monterey Dr
Deltona, FL 32738-7755
Phone (910) 995-7942
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 017422400 | Medicaid | FL |
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 |
|---|---|---|---|
| C636003930510 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592265600000",
"number": "1073138178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2064 MONTEREY DR",
"city": "DELTONA",
"state": "FL",
"postal_code": "327387755",
"telephone_number": "910-995-7942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462",
"telephone_number": "855-832-6722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "ANDREW",
"middle_name": "CHARLES",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-15",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "C636003930510",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "017422400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.