Active NPI
Anquinette Johnson, RBT
- Behavior Technician
- Palm Bay, FL
National Provider Identifier
1306592381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-204863
- Practice address
- 2180 Julian Ave NE
Palm Bay, FL 32905-4020 - Phone
- (321) 345-0861
- NPI assigned
- Feb 28, 2022
- Last updated
- Mar 1, 2022
- Sex
- Female
- Sole proprietor
- No
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 | RBT-22-204863 | FL | Primary |
Addresses
Primary practice location
2180 Julian Ave NE
Palm Bay, FL 32905-4020
Mailing address
125 E Nasa Blvd
Melbourne, FL 32901-1900
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-22-204863 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646092800000",
"number": "1306592381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 E NASA BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329011900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2180 JULIAN AVE NE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329054020",
"telephone_number": "321-345-0861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ANQUINETTE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-28",
"last_updated": "2022-03-01",
"certification_date": "2022-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-22-204863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.