Active NPI
Josh Gage Stapp, RBT
- Behavior Technician
- Crestview, FL
National Provider Identifier
1427670140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 20-118310
- Practice address
- 416 Garden St
Crestview, FL 32536-1754 - Phone
- (808) 729-6398
- Fax
- (850) 331-1480
- NPI assigned
- May 15, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 20-118310 | CO | Primary |
Addresses
Primary practice location
416 Garden St
Crestview, FL 32536-1754
Mailing address
416 Garden St
Crestview, FL 32536-1754
Phone (808) 729-6398
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 |
|---|---|---|---|
| 20-118310 | CO | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589500800000",
"number": "1427670140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 GARDEN ST",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325361754",
"telephone_number": "808-729-6398",
"fax_number": "850-331-1480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 GARDEN ST",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325361754",
"telephone_number": "808-729-6398",
"fax_number": "850-331-1480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAPP",
"first_name": "JOSH",
"middle_name": "GAGE",
"name_prefix": "Mr.",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-15",
"last_updated": "2020-05-15",
"certification_date": "2020-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "CO",
"license": "20-118310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crestview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.