Active NPI
Mireya Fambro
- Behavior Technician
- Spring Lake, NC
National Provider Identifier
1154968899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1018 N Bragg Blvd
Spring Lake, NC 28390-3316 - Phone
- (910) 295-2609
- NPI assigned
- Dec 2, 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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
1018 N Bragg Blvd
Spring Lake, NC 28390-3316
Mailing address
614 Kellam Cir
Fayetteville, NC 28311-1907
Phone (706) 224-9282
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": "1575244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575244800000",
"number": "1154968899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "614 KELLAM CIR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283111907",
"telephone_number": "706-224-9282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1018 N BRAGG BLVD",
"city": "SPRING LAKE",
"state": "NC",
"postal_code": "283903316",
"telephone_number": "910-295-2609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAMBRO",
"first_name": "MIREYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-02",
"last_updated": "2019-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Lake, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.