Individual provider Active NPI

Veronica Walker

  • Behavior Technician
  • Jacksonville, FL
National Provider Identifier
1164908984
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-18-59231 Issued in FL
Practice address
6817 Southpoint Pkwy Ste 1604
Jacksonville, FL 32216-6298
Phone
(904) 902-5957
NPI assigned
Jul 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 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-18-59231 FL Primary

Addresses

Primary practice location

6817 Southpoint Pkwy Ste 1604
Jacksonville, FL 32216-6298

Mailing address

6817 Southpoint Pkwy Ste 1604
Jacksonville, FL 32216-6298
Phone (904) 902-5957

Other practice location 1

1475 Ron Rd
Jacksonville, FL 32210-1137
Phone (855) 832-6727

Other identifiers 1

IdentifierTypeStateIssuer
024891800MedicaidFL

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-18-59231FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1531612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1164908984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY STE 1604",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166298",
            "telephone_number": "904-902-5957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY STE 1604",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166298",
            "telephone_number": "904-902-5957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1475 Ron Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322101137",
            "country_code": "US",
            "telephone_number": "855-832-6727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "VERONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-15",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-59231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024891800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.