Active NPI
Precious Kelly, RBT
- Behavior Technician
- East Orange, NJ
National Provider Identifier
1124738943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-228703
- Practice address
- 500 N Walnut St Apt 4J
East Orange, NJ 07017-4021 - Phone
- (973) 280-5449
- NPI assigned
- Dec 2, 2022
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-22-228703 | GA | Primary |
| Driver | 172A00000X | NJ | ||
| Driving and Community Mobility Occupational Therapy Assistant | 224ZR0403X |
Addresses
Primary practice location
500 N Walnut St Apt 4J
East Orange, NJ 07017-4021
Mailing address
500 N Walnut St Apt 4J
East Orange, NJ 07017-4021
Phone (973) 280-5449
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-22-228703 | GA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Precious Health and Wellness Spa Inc | Current | Accepting new patients | |
| Precious Health and Wellness Spa Inc | Behavior Technician | Current | 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.
-
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- Charlotte, NC
- NPI 1407707649
Behavior Technician
-
- Mental Health Counselor
- Charlotte, NC
- NPI 1740131176
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697155200000",
"number": "1124738943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 N WALNUT ST APT 4J",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070174021",
"telephone_number": "973-280-5449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N WALNUT ST APT 4J",
"city": "EAST ORANGE",
"state": "NJ",
"postal_code": "070174021",
"telephone_number": "973-280-5449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "PRECIOUS",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-02",
"last_updated": "2023-10-13",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-22-228703",
"primary": true
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "NJ",
"license": null,
"primary": false
},
{
"code": "224ZR0403X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant, Driving and Community Mobility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.