Active NPI
Gary Douglas
- Behavior Technician
- Tucson, AZ
National Provider Identifier
1073225504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 6700 E Speedway Blvd Ste 401
Tucson, AZ 85710-1220 - Phone
- (719) 341-1150
- NPI assigned
- Dec 15, 2022
- Reactivated
- Sep 30, 2024
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
6700 E Speedway Blvd Ste 401
Tucson, AZ 85710-1220
Mailing address
27777 Inkster Rd Ste 100
Farmington Hills, MI 48334-5312
Phone (248) 436-4400
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": "1671062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727654400000",
"number": "1073225504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27777 INKSTER RD STE 100",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483345312",
"telephone_number": "248-436-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6700 E SPEEDWAY BLVD STE 401",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857101220",
"telephone_number": "719-341-1150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "GARY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-15",
"last_updated": "2024-09-30",
"certification_date": "2024-09-30",
"deactivation_date": "2024-06-20",
"reactivation_date": "2024-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.