Active NPI
Heather Renee Fairley, RBT
- Behavior Technician
- Hattiesburg, MS
National Provider Identifier
1144787151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 18-47592
- Practice address
- 32 Millbranch Rd Ste 40
Hattiesburg, MS 39402-1673 - Phone
- (601) 255-5264
- NPI assigned
- Feb 26, 2019
- 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 | 18-47592 | MS | Primary |
Addresses
Primary practice location
32 Millbranch Rd Ste 40
Hattiesburg, MS 39402-1673
Mailing address
2612 N 9TH St
Ocean Springs, MS 39564-1008
Phone (228) 493-9583
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18-47592 | MS | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551139200000",
"number": "1144787151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2612 N 9TH ST",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395641008",
"telephone_number": "228-493-9583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 MILLBRANCH RD STE 40",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394021673",
"telephone_number": "601-255-5264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRLEY",
"first_name": "HEATHER",
"middle_name": "RENEE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-26",
"last_updated": "2019-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MS",
"license": "18-47592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.