Dyrell J Brown

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-21-160539 Issued in FL

Practice address

8493 S US Highway 1
Port Saint Lucie, FL 34952-3360

Phone

(772) 569-5699

NPI assigned

Apr 13, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CMM ABA, LLC

  • Behavior Analyst
  • Vero Beach, FL
  • NPI 1891378360

  Behavior Technician

  NPD (past)

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1164002168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4026 SW MCINTYRE ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535617",
            "telephone_number": "772-985-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8493 S US HIGHWAY 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349523360",
            "telephone_number": "772-569-5699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DYRELL",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-21-160539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109926800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea J Briner-Johnson, ARNP, FNP-C, PMHNP
• Angelica Adlene Brinson
• Catherine Brittain
• Markesha A Brockington
• Brothers & Dreams Corporation
• Elaina Marie Brown
• Ellicia Brown
• Jessica Marie Brown
• Krista Brown
• Serena Brown, DC

• Behavior Technician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.