Individual provider Active NPI

Tiffany Ann Zebold, RBT

  • Behavior Technician
  • Stuart, FL
National Provider Identifier
1154801843
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-18-62870 Issued in FL
Practice address
2400 SE Federal Hwy Ste 220
Stuart, FL 34994-4556
Phone
(772) 678-6704
NPI assigned
Aug 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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 RBT-18-62870 FL Primary

Addresses

Primary practice location

2400 SE Federal Hwy Ste 220
Stuart, FL 34994-4556

Mailing address

137 NW Broadview St
Port St Lucie, FL 34983-1615
Phone (786) 797-1015

Other practice location 1

137 NW Broadview St
Port St Lucie, FL 34983-1615
Phone (786) 797-1015

Other identifiers 1

IdentifierTypeStateIssuer
020320700MedicaidFL

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
RBT-18-62870FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1154801843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 NW BROADVIEW ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831615",
            "telephone_number": "786-797-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 SE FEDERAL HWY STE 220",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349944556",
            "telephone_number": "772-678-6704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "137 NW Broadview St",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349831615",
            "country_code": "US",
            "telephone_number": "786-797-1015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZEBOLD",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-62870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020320700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.