Individual provider Active NPI

Tiffany Nicole Watson

  • Behavior Technician
  • Dothan, AL
National Provider Identifier
1154037893
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
23-253512 Issued in AL
Practice address
3341 S Oates St
Dothan, AL 36301-5889
Phone
(850) 866-0441
NPI assigned
Jan 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 23-253512 AL Primary

Addresses

Primary practice location

3341 S Oates St
Dothan, AL 36301-5889

Mailing address

3341 S Oates St
Dothan, AL 36301-5889

Other identifiers 1

IdentifierTypeStateIssuer
23-253512MedicaidAL

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL tiffanynwatson1995@gmail.com Direct

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

LicenseStateTypeSpecialty
23-253512ALMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1154037893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3341 S OATES ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363015889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3341 S OATES ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363015889",
            "telephone_number": "850-866-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AL",
            "license": "23-253512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23-253512",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "tiffanynwatson1995@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "3341 S Oates St",
            "city": "Dothan",
            "state": "AL",
            "country_code": "US",
            "postal_code": "363015889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.

Verify at the official NPI Registry.