Kallyn Tiner

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-62131 Issued in FL

Practice address

1910 Park Meadows Dr Ste 103
Fort Myers, FL 33907-3830

Phone

(239) 260-4218

NPI assigned

May 24, 2021

Last updated

Nov 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evolve Behavior Therapy Services LLC

  • Behavior Analyst
  • Fort Myers, FL
  • NPI 1740955210
  NPD

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1326613209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 PARK MEADOWS DR STE 103",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073830",
            "telephone_number": "239-260-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 PARK MEADOWS DR STE 103",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073830",
            "telephone_number": "239-260-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINER",
        "first_name": "KALLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-22-62131",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBT CERT",
            "identifier": "RBT20121358",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "107245300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Job Timeny, DPM
• Timothy C. Runyon, D.P.M. P.a. (Certified Foot and Ankle Specialists)
• Timothy C. Runyon, DPM, PA
• Marcia F Timson, DDS
• Mara Tincher
• Robert J Tinerino
• Jennifer Velasco Ting, MD
• Dustin Clyde Tino, ATC, LAT, CSCS
• Kristin Tipps, LPC
• Rachel A Titus, M.D.

• Behavior Analyst in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.

Verify at the official NPI Registry.