Charles Anthony Smith

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

8021 36TH Ave N
St Petersburg, FL 33710-1011

Phone

(727) 458-3212

NPI assigned

Mar 6, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Behavior Modification Solutions ABA, LLC

  dba On Eagles Wings ABA

  • Behavior Analyst
  • Ocala, FL
  • NPI 1760923437
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1437651452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8021 36TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101011",
            "telephone_number": "727-458-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8021 36TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101011",
            "telephone_number": "727-458-3212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1941 Crape Myrtle Loop Apt 205",
            "address_purpose": "LOCATION",
            "city": "Lutz",
            "state": "FL",
            "postal_code": "335494008",
            "country_code": "US",
            "telephone_number": "956-454-8539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvin Smith, PHYSICAL THERAPIST
• Candace Nichole Smith, RBT
• Caren Grace Smith, A.P.R.N.
• Catherine Smith
• Cayla Kristine Smith
• Christina Lynn Smith, DNP, ARNP, NP-C
• Christine Smith
• Christine Wessels Smith, MD
• Christopher Alan Smith
• Courtney Smith

• Behavior Technician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.