Individual provider Active NPI

E'Syl Ray, BCABA

  • Assistant Behavior Analyst
  • Melbourne, FL
National Provider Identifier
1154851905
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
0-20-10916 Issued in FL
Practice address
125 E Nasa Blvd
Melbourne, FL 32901-1900
Phone
(321) 372-6813
Fax
(321) 765-6434
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-17-35692 FL
Assistant Behavior Analyst 106E00000X 0-20-10916 FL Primary

Addresses

Primary practice location

125 E Nasa Blvd
Melbourne, FL 32901-1900

Mailing address

125 E Nasa Blvd
Melbourne, FL 32901-1900
Phone (321) 372-6813

Other practice location 1

5830 US Highway 1 Ste 102
Rockledge, FL 32955-5704
Phone (321) 372-6813

Other identifiers 1

IdentifierTypeStateIssuer
02138900MedicaidFL

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-17-35692FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1154851905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E NASA BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011900",
            "telephone_number": "321-372-6813",
            "fax_number": "321-765-6434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E NASA BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011900",
            "telephone_number": "321-372-6813",
            "fax_number": "321-765-6434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5830 US Highway 1 Ste 102",
            "address_purpose": "LOCATION",
            "city": "Rockledge",
            "state": "FL",
            "postal_code": "329555704",
            "country_code": "US",
            "telephone_number": "321-372-6813",
            "fax_number": "321-765-6434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "E'SYL",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-17-35692",
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "FL",
            "license": "0-20-10916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02138900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.

Verify at the official NPI Registry.