Individual provider Active NPI

Taryn Manders, MS, BCBA

  • Behavior Analyst
  • Orlando, FL
National Provider Identifier
1376788786
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-07-3870 Issued in FL
Practice address
1609 Croydon St
Orlando, FL 32828-6851
Phone
(954) 562-2242
NPI assigned
Dec 15, 2008
Last updated
Dec 15, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-07-3870 FL Primary

Addresses

Primary practice location

1609 Croydon St
Orlando, FL 32828-6851

Mailing address

1609 Croydon St
Orlando, FL 32828-6851
Phone (954) 562-2242

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229299200000",
    "number": "1376788786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 CROYDON ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328286851",
            "telephone_number": "954-562-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 CROYDON ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328286851",
            "telephone_number": "954-562-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDERS",
        "first_name": "TARYN",
        "credential": "MS, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2008-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-07-3870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.