Individual provider Active NPI

Peyton Alexis Long, RBT

  • Behavior Technician
  • Forest Hill, MD
National Provider Identifier
1306442934
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-20-144403 Issued in MD
Practice address
501 Granary Rd
Forest Hill, MD 21050-3042
Phone
(978) 732-3982
Fax
(888) 589-1524
NPI assigned
Dec 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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 RBT-20-144403 MD Primary

Addresses

Primary practice location

501 Granary Rd
Forest Hill, MD 21050-3042

Mailing address

356C Broad Street, 3Rd Floor
Fitchburg, MA 01420
Phone (888) 589-1524

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

LicenseStateTypeSpecialty
RBT-20-144403MDMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1306442934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356C BROAD STREET, 3RD FLOOR",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "01420",
            "telephone_number": "888-589-1524",
            "fax_number": "888-589-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GRANARY RD",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210503042",
            "telephone_number": "978-732-3982",
            "fax_number": "888-589-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "PEYTON",
        "middle_name": "ALEXIS",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MD",
            "license": "RBT-20-144403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.