Individual provider Active NPI

Anthony Zizzo

  • Behavior Technician
  • Cannon Air Force Base, NM
National Provider Identifier
1083436588
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
224 W D.L. Ingram Ave
Cannon Air Force Base, NM 88103
Phone
(575) 784-1108
NPI assigned
Oct 28, 2024
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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 NU Primary

Addresses

Primary practice location

224 W D.L. Ingram Ave
Cannon Air Force Base, NM 88103

Mailing address

224 W D.L. Ingram Ave, BLDG 1408
Cannon AFB, NM 88103
Phone (575) 784-1108

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": "1730073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1083436588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 W D.L. INGRAM AVE, BLDG 1408",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "88103",
            "telephone_number": "575-784-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W D.L. INGRAM AVE",
            "city": "CANNON AIR FORCE BASE",
            "state": "NM",
            "postal_code": "88103",
            "telephone_number": "575-784-1108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIZZO",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cannon Air Force Base, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.

Verify at the official NPI Registry.