Individual provider Active NPI

Amanda Updegrove, RBT

  • Behavior Technician
  • Columbus, GA
National Provider Identifier
1356073142
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-220567 Issued in GA
Practice address
6003 Veterans Pkwy
Columbus, GA 31909-6200
Phone
(706) 222-1222
Fax
(706) 223-1934
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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 RBT-22-220567 GA Primary

Addresses

Primary practice location

6003 Veterans Pkwy
Columbus, GA 31909-6200

Mailing address

6003 Veterans Pkwy
Columbus, GA 31909-6200
Phone (706) 222-1222

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

LicenseStateTypeSpecialty
RBT-22-220567GAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Rivertown Psychiatry, PC CurrentSince Jun 18, 2023 Accepting new patients

Locations

6003 Veterans Pkwy
Columbus, GA 31909
Phone (706) 222-1222

705 17th St
Ste 410
Columbus, GA 31901
Phone (706) 223-1933

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1356073142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6003 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319096200",
            "telephone_number": "706-222-1222",
            "fax_number": "706-223-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6003 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319096200",
            "telephone_number": "706-222-1222",
            "fax_number": "706-223-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPDEGROVE",
        "first_name": "AMANDA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-22-220567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.