Active NPI
Gina Maria Clark
- Behavior Technician
- Spring Hill, FL
National Provider Identifier
1265985956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-17-32892
- Practice address
- 8212 Forest Oaks Blvd
Spring Hill, FL 34606-6839 - Phone
- (352) 584-6755
- NPI assigned
- Jul 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Behavior Technician | 106S00000X | RBT-17-32892 | FL | Primary |
Addresses
Primary practice location
8212 Forest Oaks Blvd
Spring Hill, FL 34606-6839
Mailing address
8212 Forest Oaks Blvd
Spring Hill, FL 34606-6839
Phone (352) 584-6755
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-17-32892 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557360000000",
"number": "1265985956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8212 FOREST OAKS BLVD",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "346066839",
"telephone_number": "352-584-6755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8212 FOREST OAKS BLVD",
"city": "SPRING HILL",
"state": "FL",
"postal_code": "346066839",
"telephone_number": "352-584-6755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "GINA",
"middle_name": "MARIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-28",
"last_updated": "2019-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-17-32892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Hill, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.