Individual provider Active NPI

Charis Brassell

  • Behavior Technician
  • Orlando, FL
National Provider Identifier
1154886281
Registry record updated Feb 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5722 Bay Side Dr
Orlando, FL 32819-4034
Phone
(831) 252-6490
NPI assigned
Feb 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2019

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
Behavior Technician 106S00000X FL Primary

Addresses

Primary practice location

5722 Bay Side Dr
Orlando, FL 32819-4034

Mailing address

500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817

Other practice location 1

5722 Bay Side Dr
Orlando, FL 32819-4034
Phone (831) 252-6490

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

NPI Registry JSON

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

{
    "created_epoch": "1549152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549152000000",
    "number": "1154886281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FAIRWAY DR STE 102",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5722 BAY SIDE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328194034",
            "telephone_number": "831-252-6490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5722 Bay Side Dr",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328194034",
            "country_code": "US",
            "telephone_number": "831-252-6490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRASSELL",
        "first_name": "CHARIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-03",
        "last_updated": "2019-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.

Verify at the official NPI Registry.