Active NPI
Laura Amanda Waitt, RBT
- Behavior Technician
- Daytona Beach Shores, FL
National Provider Identifier
1467228619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-309623
- Practice address
- 3408 S Atlantic Ave
Daytona Beach Shores, FL 32118-6311 - Phone
- (386) 767-3752
- NPI assigned
- Nov 29, 2023
- Last updated
- Aug 13, 2024
- 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-23-309623 | FL | Primary |
Addresses
Primary practice location
3408 S Atlantic Ave
Daytona Beach Shores, FL 32118-6311
Mailing address
3949 Sunset Cove Dr
Port Orange, FL 32129-1917
Phone (404) 640-9476
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-23-309623 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Independence | Behavior Technician | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1467228619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3949 SUNSET COVE DR",
"city": "PORT ORANGE",
"state": "FL",
"postal_code": "321291917",
"telephone_number": "404-640-9476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3408 S ATLANTIC AVE",
"city": "DAYTONA BEACH SHORES",
"state": "FL",
"postal_code": "321186311",
"telephone_number": "386-767-3752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITT",
"first_name": "LAURA",
"middle_name": "AMANDA",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-29",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-23-309623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daytona Beach Shores, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.