Active NPI
Charles Brian Meredith
- Behavior Technician
- Daytona Beach Shores, FL
National Provider Identifier
1174238703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-253447
- Practice address
- 3408 South Atlantic Ave.
PMB 1052
Daytona Beach Shores, FL 32118 - Phone
- (386) 767-3752
- NPI assigned
- Jan 18, 2023
- Sex
- Male
- 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 | RBT-23-253447 | FL | Primary |
Addresses
Primary practice location
3408 South Atlantic Ave.
PMB 1052
Daytona Beach Shores, FL 32118
Mailing address
3408 South Atlantic Ave.
PMB 1052
Daytona Beach Shores, FL 32118
Phone (386) 767-3752
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-23-253447 | Other | FL | BACB |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-23-253447 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1174238703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3408 SOUTH ATLANTIC AVE.",
"address_2": "PMB 1052",
"city": "DAYTONA BEACH SHORES",
"state": "FL",
"postal_code": "32118",
"telephone_number": "386-767-3752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3408 SOUTH ATLANTIC AVE.",
"address_2": "PMB 1052",
"city": "DAYTONA BEACH SHORES",
"state": "FL",
"postal_code": "32118",
"telephone_number": "386-767-3752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEREDITH",
"first_name": "CHARLES",
"middle_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-18",
"last_updated": "2023-01-18",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-23-253447",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB",
"identifier": "RBT-23-253447",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Daytona Beach Shores, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.