Active NPI
Octavia Johnson
- Behavior Technician
- Palm Beach Gardens, FL
National Provider Identifier
1396519203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-251431
- Practice address
- 12501 Woodmill Dr
Palm Beach Gardens, FL 33418-8938 - Phone
- (561) 768-4488
- NPI assigned
- Nov 10, 2023
- Sex
- Female
- Sole proprietor
- No
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 | RBT-22-251431 | FL | Primary |
Addresses
Primary practice location
12501 Woodmill Dr
Palm Beach Gardens, FL 33418-8938
Mailing address
799 Hill Dr Apt B
West Palm Beach, FL 33415-4002
Phone (561) 603-6914
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 |
|---|---|---|---|
| RBT-22-251431 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monarch Circle LLC | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699574400000",
"number": "1396519203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "799 HILL DR APT B",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334154002",
"telephone_number": "561-603-6914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12501 WOODMILL DR",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334188938",
"telephone_number": "561-768-4488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "OCTAVIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-10",
"last_updated": "2023-11-10",
"certification_date": "2023-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-22-251431",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Beach Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.