Active NPI
Caitlyn Marie-Rose Corn, RBT
- Behavior Analyst
- Fort Walton Beach, FL
National Provider Identifier
1144882010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- RBT-19-90242
- Practice address
- 103 Lewis St
Fort Walton Beach, FL 32547-3142 - Phone
- (850) 362-6824
- NPI assigned
- Jul 1, 2019
- Last updated
- Jul 1, 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 Analyst | 103K00000X | RBT-19-90242 | FL | Primary |
Addresses
Primary practice location
103 Lewis St
Fort Walton Beach, FL 32547-3142
Mailing address
947 Bel Aire Dr # 947
Crestview, FL 32536-3228
Phone (757) 708-5731
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 |
|---|---|---|---|
| RBT-19-90242 | FL | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beyond Expectations Inc. | Behavior Analyst | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Fort Walton Beach, FL
- NPI 1114278686
Behavior Analyst
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561939200000",
"number": "1144882010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "947 BEL AIRE DR # 947",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325363228",
"telephone_number": "757-708-5731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 LEWIS ST",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325473142",
"telephone_number": "850-362-6824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORN",
"first_name": "CAITLYN",
"middle_name": "MARIE-ROSE",
"name_prefix": "Mrs.",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-01",
"last_updated": "2019-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "RBT-19-90242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.