Individual provider Active NPI

Beyonce Lashonda Johnson

  • Behavior Technician
  • Tampa, FL
National Provider Identifier
1104716075
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
3109 W Dr Martin Luther King Jr Blvd Ste 500
Tampa, FL 33607-6220
Phone
(813) 289-0760
NPI assigned
Jul 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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 Primary

Addresses

Primary practice location

3109 W Dr Martin Luther King Jr Blvd Ste 500
Tampa, FL 33607-6220

Mailing address

3109 W Dr Martin Luther King Jr Blvd Ste 500
Tampa, FL 33607-6220
Phone (813) 289-0760

Other practice location 1

13139 W Linebaugh Ave Ste 102
Tampa, FL 33626-4498
Phone (877) 823-4283

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

Practice roles

OrganizationSpecialtyStatusNew patients
Maxim Healthcare Services, Inc. PastSince Aug 17, 2025 Accepting new patients
Maxim Healthcare Services, Inc PastSince Aug 17, 2025 Accepting new patients

Organizations & group practices 2

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": "1751500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1104716075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3109 W DR MARTIN LUTHER KING JR BLVD STE 500",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076220",
            "telephone_number": "813-289-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 W DR MARTIN LUTHER KING JR BLVD STE 500",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076220",
            "telephone_number": "813-289-0760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13139 W Linebaugh Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336264498",
            "country_code": "US",
            "telephone_number": "877-823-4283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BEYONCE",
        "middle_name": "LASHONDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; 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.