Individual provider Active NPI

Stanie Mesamour

  • Behavior Technician
  • Fort Myers, FL
National Provider Identifier
1104607464
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-297089 Issued in FL
Practice address
9648 Windsor Gardens LN Apt 202
Fort Myers, FL 33919-8402
Phone
(754) 213-9795
NPI assigned
Oct 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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-23-297089 FL Primary

Addresses

Primary practice location

9648 Windsor Gardens LN Apt 202
Fort Myers, FL 33919-8402

Mailing address

9648 Windsor Gardens LN Apt 202
Fort Myers, FL 33919-8402
Phone (754) 213-9795

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-23-297089FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1104607464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9648 WINDSOR GARDENS LN APT 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198402",
            "telephone_number": "754-213-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9648 WINDSOR GARDENS LN APT 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198402",
            "telephone_number": "754-213-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESAMOUR",
        "first_name": "STANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-23-297089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.