Active NPI
Sydney Nichole Mogler
- Behavior Technician
- Stuart, FL
National Provider Identifier
1194489005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB717291
- Practice address
- 821 SE Ocean Blvd Ste Bandc
Stuart, FL 34994-2456 - Phone
- (772) 872-6940
- Fax
- (772) 209-6900
- NPI assigned
- Oct 26, 2021
- 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 | BACB717291 | FL | Primary |
Addresses
Primary practice location
821 SE Ocean Blvd Ste Bandc
Stuart, FL 34994-2456
Mailing address
3344 NE Sandra Dr
Jensen Beach, FL 34957-3972
Phone (931) 303-1769
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112065700 | Medicaid | FL |
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 |
|---|---|---|---|
| BACB717291 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1194489005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3344 NE SANDRA DR",
"city": "JENSEN BEACH",
"state": "FL",
"postal_code": "349573972",
"telephone_number": "931-303-1769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "821 SE OCEAN BLVD STE BANDC",
"city": "STUART",
"state": "FL",
"postal_code": "349942456",
"telephone_number": "772-872-6940",
"fax_number": "772-209-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGLER",
"first_name": "SYDNEY",
"middle_name": "NICHOLE",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-26",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "BACB717291",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112065700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.