Active NPI
Darryl Anthony Jenkins Jr.
- Behavior Technician
- Melbourne, FL
National Provider Identifier
1396562807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 1780 Stewart PL
Melbourne, FL 32935-4304 - Phone
- (321) 831-7834
- NPI assigned
- Sep 25, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-386978 | FL | |
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
1780 Stewart PL
Melbourne, FL 32935-4304
Mailing address
478 N Babcock St Ste 115
Melbourne, FL 32935-6923
Phone (321) 972-4265
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-24-386978 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729555200000",
"number": "1396562807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "478 N BABCOCK ST STE 115",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329356923",
"telephone_number": "321-972-4265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1780 STEWART PL",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329354304",
"telephone_number": "321-831-7834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENKINS",
"first_name": "DARRYL",
"middle_name": "ANTHONY",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-25",
"last_updated": "2024-10-22",
"certification_date": "2024-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-24-386978",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.