Individual provider Active NPI

Alexis Drew Pullara

  • Behavior Technician
  • Salisbury, MD
National Provider Identifier
1346722857
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
420 E North Pointe Dr Apt 460
Salisbury, MD 21804-2354
Phone
(443) 365-5077
NPI assigned
Aug 30, 2018
Last updated
Aug 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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 MD Primary

Addresses

Primary practice location

420 E North Pointe Dr Apt 460
Salisbury, MD 21804-2354

Mailing address

10514 Racetrack Rd
Berlin, MD 21811-3241
Phone (410) 973-2301

Other identifiers 1

IdentifierTypeStateIssuer
483106300MedicaidMD

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": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1346722857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10514 RACETRACK RD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113241",
            "telephone_number": "410-973-2301",
            "fax_number": "410-973-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E NORTH POINTE DR APT 460",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218042354",
            "telephone_number": "443-365-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULLARA",
        "first_name": "ALEXIS",
        "middle_name": "DREW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "483106300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.