Active NPI
Jacqueline Royster
- Behavior Technician
- Winter Haven, FL
National Provider Identifier
1407477573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-115425
- Practice address
- 828 Avenue N SW
Winter Haven, FL 33880-3846 - Phone
- (407) 789-4619
- NPI assigned
- Apr 30, 2020
- Sex
- Female
- 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 | RBT-20-115425 | FL | Primary |
Addresses
Primary practice location
828 Avenue N SW
Winter Haven, FL 33880-3846
Mailing address
2692 Whispering Trails Dr
Winter Haven, FL 33884-1843
Phone (863) 875-9980
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-20-115425 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679875200000",
"number": "1407477573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2692 WHISPERING TRAILS DR",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338841843",
"telephone_number": "863-875-9980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "828 AVENUE N SW",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338803846",
"telephone_number": "407-789-4619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROYSTER",
"first_name": "JACQUELINE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-30",
"last_updated": "2023-03-27",
"certification_date": "2023-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-20-115425",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.