Active NPI
Walter Kevin Steele, EMT P120704
- Behavior Technician
- Indian Trail, NC
National Provider Identifier
1376161836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 106500000X
- Practice address
- 5428 Friendly Baptist CH Rd
Indian Trail, NC 28079-7797 - Phone
- (704) 989-6180
- NPI assigned
- Jul 10, 2020
- 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 | 106500000X | NC | Primary |
Addresses
Primary practice location
5428 Friendly Baptist CH Rd
Indian Trail, NC 28079-7797
Mailing address
5428 Friendly Baptist CH Rd
Indian Trail, NC 28079-7797
Phone (704) 989-6180
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P120704 | Other | NC | EMT |
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 |
|---|---|---|---|
| 106500000X | NC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594339200000",
"number": "1376161836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5428 FRIENDLY BAPTIST CH RD",
"city": "INDIAN TRAIL",
"state": "NC",
"postal_code": "280797797",
"telephone_number": "704-989-6180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5428 FRIENDLY BAPTIST CH RD",
"city": "INDIAN TRAIL",
"state": "NC",
"postal_code": "280797797",
"telephone_number": "704-989-6180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEELE",
"first_name": "WALTER",
"middle_name": "KEVIN",
"name_prefix": "Mr.",
"credential": "EMT P120704",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-10",
"last_updated": "2020-07-10",
"certification_date": "2020-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NC",
"license": "106500000X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMT",
"identifier": "P120704",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indian Trail, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.