Roderick Louis Matheson III

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-22-229670 Issued in FL

Practice address

2180 Julian Ave NE
Palm Bay, FL 32905-4020

Phone

(321) 345-0861

NPI assigned

Aug 15, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kaleidoscope Interventions

  • Behavior Analyst
  • Rockledge, FL
  • NPI 1902200116
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1104544303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 WEDGEWOOD DR NE APT 201",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329056230",
            "telephone_number": "321-363-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 JULIAN AVE NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054020",
            "telephone_number": "321-345-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHESON",
        "first_name": "RODERICK",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-22-229670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roderickm@thepiecefits.com",
            "affiliation": "Y",
            "affiliationName": "Kaleidoscope Interventions",
            "address_1": "2180 Julian Ave NE",
            "city": "Palm Bay",
            "state": "FL",
            "country_code": "US",
            "postal_code": "329054020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Teresa Martini Jr
• Thomas Michael Martinko, MD
• Henry L Mason III, DMD
• Natalie Areej Masri, DMD
• Kevin Vincent Masturzo, LCSW
• Mark Stephen Mathusa Jr.
• Daniuska Matos Colome
• Ariana Michel Lauren Matos
• Helen Elizabeth May, D.D.S
• Ebony L Maynard, APRN

• Behavior Technician in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.