Mallory E Amrhein, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

18-61117 Issued in FL

Practice address

419 Racetrack Rd NW
Fort Walton Beach, FL 32547-4612

Phone

(850) 862-3728

Fax

(850) 862-6270

NPI assigned

Jul 20, 2018

Sex

Female

Sole proprietor

No

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.

• Complete Rehabilitation Services, Inc.

  • Speech-Language Assistant
  • Fort Walton Beach, FL
  • NPI 1356446546
  NPD (past)

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1215414529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 LEWIS TURNER BLVD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471316",
            "telephone_number": "850-862-3728",
            "fax_number": "850-862-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 RACETRACK RD NW",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325474612",
            "telephone_number": "850-862-3728",
            "fax_number": "850-862-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMRHEIN",
        "first_name": "MALLORY",
        "middle_name": "E",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "18-61117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18-61117",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Keith Amiel, OD
• Michelle Ammon, M.ED., BCBA
• Gregory Ammons
• Shannon L Amos, M.A., CCC-SLP
• Warren R. Amos, MD
• Alexis Esperanza Amy, QASP-S
• Patrick John Anastasio, D.O.
• Shareen Ancog
• Deanna Ruth Anderson
• Elizabeth Gayle Anderson, ARNP-C

• All providers in Fort Walton Beach, FL
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.