Individual provider Active NPI

Olivia Ann Smerdon

  • Behavior Technician
  • Ponte Vedra Beach, FL
National Provider Identifier
1366237992
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
130 Corridor Rd Unit 3292
Ponte Vedra Beach, FL 32004-7833
Phone
(904) 206-8804
NPI assigned
Apr 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary
Behavior Technician 106S00000X RBT-25-439379 FL

Addresses

Primary practice location

130 Corridor Rd Unit 3292
Ponte Vedra Beach, FL 32004-7833

Mailing address

41 Ponte Vedra Colony Cir
Ponte Vedra, FL 32082-2716
Phone (386) 289-7419

Other practice location 1

41 Ponte Vedra Colony Cir
Ponte Vedra, FL 32082-2716
Phone (386) 289-7419

Other practice location 2

7775 Baymeadows Way Ste 200
Jacksonville, FL 32256-7531
Phone (410) 910-3589

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-25-439379FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1366237992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PONTE VEDRA COLONY CIR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320822716",
            "telephone_number": "386-289-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CORRIDOR RD UNIT 3292",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320047833",
            "telephone_number": "904-206-8804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Ponte Vedra Colony Cir",
            "address_purpose": "LOCATION",
            "city": "Ponte Vedra",
            "state": "FL",
            "postal_code": "320822716",
            "country_code": "US",
            "telephone_number": "386-289-7419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7775 Baymeadows Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322567531",
            "country_code": "US",
            "telephone_number": "410-910-3589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMERDON",
        "first_name": "OLIVIA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-25-439379",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.