Individual provider Active NPI

Cameel Rachael Wellington Walls

  • Assistant Behavior Analyst
  • Cooper City, FL
National Provider Identifier
1215464722
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
12260 SW 53Rd St # 211
Cooper City, FL 33330-3320
Phone
(954) 499-5794
Fax
(954) 252-4844
NPI assigned
May 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X Primary

Addresses

Primary practice location

12260 SW 53Rd St # 211
Cooper City, FL 33330-3320

Mailing address

12260 SW 53Rd St # 211
Cooper City, FL 33330-3320
Phone (954) 499-5794

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

NPI Registry JSON

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215464722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12260 SW 53RD ST # 211",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333303320",
            "telephone_number": "954-499-5794",
            "fax_number": "954-252-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12260 SW 53RD ST # 211",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333303320",
            "telephone_number": "954-499-5794",
            "fax_number": "954-252-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLINGTON WALLS",
        "first_name": "CAMEEL",
        "middle_name": "RACHAEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooper City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.