Individual provider Active NPI

Angelita Davis

  • Behavior Technician
  • Fayetteville, NC
National Provider Identifier
1285557330
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
16173 Issued in NC
Practice address
2919 Breezewood Ave Ste 202
Fayetteville, NC 28303-5283
Phone
(910) 263-8986
NPI assigned
Aug 4, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 16173 NC Primary

Addresses

Primary practice location

2919 Breezewood Ave Ste 202
Fayetteville, NC 28303-5283

Mailing address

2919 Breezewood Ave Ste 202
Fayetteville, NC 28303-5283
Phone (910) 263-8986

Other names 1

  • Angelita Jacobs Former name

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": "1785801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1285557330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 BREEZEWOOD AVE STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035283",
            "telephone_number": "910-263-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 BREEZEWOOD AVE STE 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035283",
            "telephone_number": "910-263-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANGELITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-04",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": "16173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELITA",
            "last_name": "JACOBS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.