Active NPI
Katelyn Bruno, RBT
- Behavior Technician
- Brunswick, GA
National Provider Identifier
1134744337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-122915
- Practice address
- 2300 Parkwood Dr
Brunswick, GA 31520-4719 - Phone
- (912) 399-4247
- NPI assigned
- Jun 12, 2020
- 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 | RBT-20-122915 | Primary |
Addresses
Primary practice location
2300 Parkwood Dr
Brunswick, GA 31520-4719
Mailing address
2300 Parkwood Dr
Brunswick, GA 31520-4719
Phone (912) 399-4247
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Light of Hope Learning Center | Behavior Technician | Current | Accepting new patients |
Locations
2300 Parkwood Dr
Brunswick, GA 31520
Phone (912) 267-6006
Organizations & group practices 1
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": "1591920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591920000000",
"number": "1134744337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 PARKWOOD DR",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315204719",
"telephone_number": "912-399-4247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 PARKWOOD DR",
"city": "BRUNSWICK",
"state": "GA",
"postal_code": "315204719",
"telephone_number": "912-399-4247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNO",
"first_name": "KATELYN",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-12",
"last_updated": "2020-06-12",
"certification_date": "2020-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": "RBT-20-122915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brunswick, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.