Kendra M Anderson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1907 Tyrone Blvd N
St Petersburg, FL 33710-4841

Phone

(727) 827-2838

Fax

(727) 201-4107

NPI assigned

Dec 19, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

• Skyway Behavior Center

  • Behavior Analyst
  • St Petersburg, FL
  • NPI 1366816464
  NPD (past)

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1114296308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104841",
            "telephone_number": "727-827-2838",
            "fax_number": "727-201-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 TYRONE BLVD N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337104841",
            "telephone_number": "727-827-2838",
            "fax_number": "727-201-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KENDRA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "66040",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Fine Anderson, DMD, PA
• Brian Mark Anderson, P.T.
• Crista Anderson
• Doris Stalls Anderson, LCSW
• Haley Michael Anderson
• Melanie Anne Anderson, MD
• Nancy Lynn Anderson, N/A
• Rebecca Anderson
• Robyn Anderson
• Sandra Anderson

• Behavior Technician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.