Individual provider Active NPI

Kalista Ray Caplan

  • Behavior Technician
  • Stuart, FL
National Provider Identifier
1396484549
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
21-192914 Issued in FL
Practice address
1699 NW Britt Rd
Stuart, FL 34994-9214
Phone
(772) 631-4157
NPI assigned
Jun 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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
Behavior Technician 106S00000X 21-192914 FL Primary

Addresses

Primary practice location

1699 NW Britt Rd
Stuart, FL 34994-9214

Mailing address

821 SE Ocean Blvd
Stuart, FL 34994-2456
Phone (772) 872-6940

Other identifiers 1

IdentifierTypeStateIssuer
1128395MedicaidFL

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
21-192914FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1396484549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 SE OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942456",
            "telephone_number": "772-872-6940",
            "fax_number": "772-209-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 NW BRITT RD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349949214",
            "telephone_number": "772-631-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPLAN",
        "first_name": "KALISTA",
        "middle_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "21-192914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1128395",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.