Active NPI
Wende Sumner
- Behavior Technician
- Tennille, GA
National Provider Identifier
1457987018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-100972
- Practice address
- 732 Old Watermelon Rd
Tennille, GA 31089-5544 - Phone
- (810) 599-2129
- NPI assigned
- Mar 16, 2020
- Last updated
- Mar 16, 2020
- 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-19-100972 | GA | Primary |
Addresses
Primary practice location
732 Old Watermelon Rd
Tennille, GA 31089-5544
Mailing address
PO Box 663
Lakeland, MI 48143-0663
Phone (810) 559-2129
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-19-100972 | GA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enhanced Behavioral Respite Inc. | Current | Accepting new patients | |
| ABA Pathways, LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Child Intellectual and/or Developmental Disabilities Respite Care
- Saginaw, MI
- NPI 1619503356
-
- Behavior Analyst
- Ann Arbor, MI
- NPI 1770838468
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584316800000",
"number": "1457987018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 663",
"city": "LAKELAND",
"state": "MI",
"postal_code": "481430663",
"telephone_number": "810-559-2129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "732 OLD WATERMELON RD",
"city": "TENNILLE",
"state": "GA",
"postal_code": "310895544",
"telephone_number": "810-599-2129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMNER",
"first_name": "WENDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-16",
"last_updated": "2020-03-16",
"certification_date": "2020-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-19-100972",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tennille, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.