Active NPI
Madison Samone Rivera
- Behavior Technician
- Tampa, FL
National Provider Identifier
1326779364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-221176
- Practice address
- 4018 W Lawn Ave
Tampa, FL 33611-1334 - Phone
- (813) 461-5380
- Fax
- (813) 642-4502
- NPI assigned
- Jun 21, 2022
- Last updated
- Jun 21, 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-22-221176 | FL | Primary |
Addresses
Primary practice location
4018 W Lawn Ave
Tampa, FL 33611-1334
Mailing address
4018 W Lawn Ave
Tampa, FL 33611-1334
Phone (813) 461-5380
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-22-22--1176 | Other | FL | REGISTERED BEHAVIOR TECHNITIAN |
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-22-221176 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655769600000",
"number": "1326779364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4018 W LAWN AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336111334",
"telephone_number": "813-461-5380",
"fax_number": "813-642-4502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4018 W LAWN AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336111334",
"telephone_number": "813-461-5380",
"fax_number": "813-642-4502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "MADISON",
"middle_name": "SAMONE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-21",
"last_updated": "2022-06-21",
"certification_date": "2022-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-22-221176",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED BEHAVIOR TECHNITIAN",
"identifier": "RBT-22-22--1176",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.