Active NPI
Aaron Moultrie
- Behavior Technician
- Wesley Chapel, FL
National Provider Identifier
1417612599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB647808
- Practice address
- 30250 Southwell LN
Wesley Chapel, FL 33543-5926 - Phone
- (407) 456-2722
- NPI assigned
- Nov 3, 2021
- 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 | BACB647808 | FL | Primary |
Addresses
Primary practice location
30250 Southwell LN
Wesley Chapel, FL 33543-5926
Mailing address
6675 38TH Ave N Ste 104
Saint Petersburg, FL 33710-1534
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 |
|---|---|---|---|
| BACB647808 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647561600000",
"number": "1417612599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6675 38TH AVE N STE 104",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337101534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30250 SOUTHWELL LN",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335435926",
"telephone_number": "407-456-2722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOULTRIE",
"first_name": "AARON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-03",
"last_updated": "2022-03-18",
"certification_date": "2022-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "BACB647808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wesley Chapel, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.