Individual provider Active NPI

Camisha Renee Burroughs, RBT

  • Behavior Technician
  • Spring Lake, NC
National Provider Identifier
1336784651
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1018 N Bragg Blvd
Spring Lake, NC 28390-3316
Phone
(910) 977-5130
NPI assigned
Nov 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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 Primary

Addresses

Primary practice location

1018 N Bragg Blvd
Spring Lake, NC 28390-3316

Mailing address

1018 N Bragg Blvd
Spring Lake, NC 28390-3316
Phone (910) 977-5130

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": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1336784651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 N BRAGG BLVD",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283903316",
            "telephone_number": "910-977-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 N BRAGG BLVD",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283903316",
            "telephone_number": "910-977-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROUGHS",
        "first_name": "CAMISHA",
        "middle_name": "RENEE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; 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.