Individual provider Active NPI

Grace Isabella McMinn, RBT

  • Behavior Technician
  • Lake Worth, FL
National Provider Identifier
1457137960
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-288206 Issued in FL
Practice address
9815 Cross Pine CT
Lake Worth, FL 33467-2367
Phone
(561) 223-8076
NPI assigned
Aug 31, 2023
Last updated
Aug 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-23-288206 FL Primary

Addresses

Primary practice location

9815 Cross Pine CT
Lake Worth, FL 33467-2367

Mailing address

2170 Polo Gardens Dr Apt 207
Wellington, FL 33414-2030
Phone (863) 444-3463

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

LicenseStateTypeSpecialty
RBT-23-288206FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1457137960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 POLO GARDENS DR APT 207",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334142030",
            "telephone_number": "863-444-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9815 CROSS PINE CT",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672367",
            "telephone_number": "561-223-8076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMINN",
        "first_name": "GRACE",
        "middle_name": "ISABELLA",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-23-288206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.

Verify at the official NPI Registry.