Active NPI
Julie Ann Novak-Eversole
- Behavior Technician
- Washington, MO
National Provider Identifier
1427635671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-122274
- Practice address
- 266 Landera Lane
Washington, MO 63090 - Phone
- (573) 480-0440
- NPI assigned
- Mar 25, 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 | RBT-20-122274 | MO | Primary |
Addresses
Primary practice location
266 Landera Lane
Washington, MO 63090
Mailing address
266 Landera Lane
Washington, MO 63090
Phone (573) 480-0440
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-20-122274 | MO | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bloom Behavior Services LLC | Behavior Technician | Current | 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": "1616630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616630400000",
"number": "1427635671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "266 LANDERA LANE",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "63090",
"telephone_number": "573-480-0440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "266 LANDERA LANE",
"city": "WASHINGTON",
"state": "MO",
"postal_code": "63090",
"telephone_number": "573-480-0440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVAK-EVERSOLE",
"first_name": "JULIE",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-25",
"last_updated": "2021-03-25",
"certification_date": "2021-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MO",
"license": "RBT-20-122274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.