Active NPI
Michael S Wyatt Jr., RBT
- Behavior Technician
- Fort Wayne, IN
National Provider Identifier
1285512129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT25447193
- Practice address
- 5750 Falls Dr
Fort Wayne, IN 46804-7147 - Phone
- (260) 204-5719
- NPI assigned
- Aug 26, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 | RBT25447193 | IN | Primary |
Addresses
Primary practice location
5750 Falls Dr
Fort Wayne, IN 46804-7147
Mailing address
5750 Falls Dr
Fort Wayne, IN 46804-7147
Phone (260) 204-5719
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 |
|---|---|---|---|
| RBT25447193 | IN | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756166400000",
"number": "1285512129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5750 FALLS DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047147",
"telephone_number": "260-204-5719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5750 FALLS DR",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468047147",
"telephone_number": "260-204-5719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "MICHAEL",
"middle_name": "S",
"name_prefix": "Prof.",
"name_suffix": "Jr.",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-08-26",
"last_updated": "2025-08-26",
"certification_date": "2025-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT25447193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.