Individual provider Active NPI

Charlotte Tomevi

  • Behavior Analyst
  • Homedale, ID
National Provider Identifier
1104239045
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-17-26141 Issued in ID
Practice address
17 Kansas Ave
Homedale, ID 83628-3417
Phone
(208) 741-3838
Fax
(208) 498-2026
NPI assigned
Jun 9, 2014
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavioral Solutions, LLC Behavior Analyst Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-17-26141 ID Primary

Addresses

NPPES NPI Registry

Primary practice location

17 Kansas Ave
Homedale, ID 83628-3417

Mailing address

17 Kansas Ave
Homedale, ID 83628-3417
Phone (208) 741-3838

Other practice location 1

25 W 5th Ave
Spokane, WA 99204-4601
Phone (509) 328-1582

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 30, 2018.

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522368000000",
    "number": "1104239045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 KANSAS AVE",
            "city": "HOMEDALE",
            "state": "ID",
            "postal_code": "836283417",
            "telephone_number": "208-741-3838",
            "fax_number": "208-498-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 KANSAS AVE",
            "city": "HOMEDALE",
            "state": "ID",
            "postal_code": "836283417",
            "telephone_number": "208-741-3838",
            "fax_number": "208-498-2026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 W 5th Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992044601",
            "country_code": "US",
            "telephone_number": "509-328-1582",
            "fax_number": "877-376-3335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMEVI",
        "first_name": "CHARLOTTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2018-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "ID",
            "license": "1-17-26141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homedale, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.