Ethan M Kenyon, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-21-178116 Issued in FL

Practice address

500 E Colonial Dr
Orlando, FL 32803-4510

Phone

(407) 218-4340

Fax

(407) 218-4303

NPI assigned

Aug 17, 2021

Last updated

Aug 17, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Life Concepts Inc

  dba Quest, Inc.

  • Behavior Analyst
  • Orlando, FL
  • NPI 1003238536
  NPD (past)

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1366118705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 E COLONIAL DR STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034729",
            "telephone_number": "407-218-4340",
            "fax_number": "407-218-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034510",
            "telephone_number": "407-218-4340",
            "fax_number": "407-218-4303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1939 Boothe Cir",
            "address_purpose": "LOCATION",
            "city": "Longwood",
            "state": "FL",
            "postal_code": "327506774",
            "country_code": "US",
            "telephone_number": "407-218-4340",
            "fax_number": "407-218-4303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KENYON",
        "first_name": "ETHAN",
        "middle_name": "M",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-21-178116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katlynn Danielle Kenon, MD
• Kent Clinic, LLC
• Jennifer Elizabeth Kent-Walsh, PH.D., CCC-SLP
• Shawna Elizabeth Kent, LMT
• Jacqueline Dione Kenton, PMHNP-BC
• Michael George Keotahlian, D.C
• Lisa M Keough, OTR/L
• Marcy Lynn Keown, D.M.D.
• Brittany Kepler
• Angela Keppol

• Behavior Technician in Orlando, FL
• Providers in Orlando, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.