Active NPI
Kenyan X Lewis
- Behavior Technician
- Lauderdale Lakes, FL
National Provider Identifier
1336928753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-299959
- Practice address
- 4291 NW 45TH St
Lauderdale Lakes, FL 33319-3870 - Phone
- (754) 214-7687
- NPI assigned
- Sep 25, 2023
- Sex
- Male
- Sole proprietor
- Yes
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-23-299959 | FL | Primary |
Addresses
Primary practice location
4291 NW 45TH St
Lauderdale Lakes, FL 33319-3870
Mailing address
3170 N Federal Hwy Ste 209
Pompano Beach, FL 33064-6722
Phone (195) 486-6143
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-23-299959 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1336928753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3170 N FEDERAL HWY STE 209",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330646722",
"telephone_number": "195-486-6143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4291 NW 45TH ST",
"city": "LAUDERDALE LAKES",
"state": "FL",
"postal_code": "333193870",
"telephone_number": "754-214-7687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "KENYAN",
"middle_name": "X",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-25",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-23-299959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lauderdale Lakes, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.