Individual provider Active NPI

Mikiah Devastae Heard

  • Behavior Technician
  • Columbus, GA
National Provider Identifier
1093538043
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-390768 Issued in GA
Practice address
2357 Warm Springs Rd Ste 119
Columbus, GA 31904-5690
Phone
(706) 309-2233
NPI assigned
Nov 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 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 RBT-24-390768 GA Primary

Addresses

Primary practice location

2357 Warm Springs Rd Ste 119
Columbus, GA 31904-5690

Mailing address

307 International Cir Ste 100
Hunt Valley, MD 21030-1387
Phone (910) 218-1602

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-24-390768GAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Therapeutic Services CurrentSince Nov 10, 2024 Accepting new patients

Locations

2357 Warm Springs Rd
Ste 119
Columbus, GA 31904
Phone (229) 458-9165

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": "1730851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1093538043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 INTERNATIONAL CIR STE 100",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210301387",
            "telephone_number": "910-218-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2357 WARM SPRINGS RD STE 119",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319045690",
            "telephone_number": "706-309-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARD",
        "first_name": "MIKIAH",
        "middle_name": "DEVASTAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-24-390768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.