Active NPI
Rhema Marvanne-Voraritskul Bryan
- Behavior Technician
- East Tawas, MI
National Provider Identifier
1104582162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 111 Newman St
East Tawas, MI 48730-1272 - Phone
- (844) 244-1818
- NPI assigned
- Nov 15, 2021
- Sex
- Female
- 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
111 Newman St
East Tawas, MI 48730-1272
Mailing address
1500 S Douglas Rd Ste 230
Coral Gables, FL 33134-4108
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1259304094 | Medicaid | MI |
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": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1104582162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 S DOUGLAS RD STE 230",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331344108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 NEWMAN ST",
"city": "EAST TAWAS",
"state": "MI",
"postal_code": "487301272",
"telephone_number": "844-244-1818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "RHEMA",
"middle_name": "MARVANNE-VORARITSKUL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-15",
"last_updated": "2021-11-15",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1259304094",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Tawas, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.