Individual provider Active NPI

Nikeda Stanback

  • Behavior Analyst
  • Boca Raton, FL
National Provider Identifier
1477936656
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
20283 State Road 7 Ste 400
Boca Raton, FL 33498-6904
Phone
(954) 866-1430
NPI assigned
Jul 7, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

20283 State Road 7 Ste 400
Boca Raton, FL 33498-6904

Mailing address

20283 State Road 7 Ste 400
Boca Raton, FL 33498-6904
Phone (954) 866-1430

Other practice location 1

2541 N Bouvier St
Philadelphia, PA 19132-3816
Phone (267) 574-2457

Other practice location 2

1201 E Sunrise Blvd # 4-705
Fort Lauderdale, FL 33304-2880
Phone (267) 574-5457

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL outsidetheboxabaservices@gmail.com Direct

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1477936656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20283 STATE ROAD 7 STE 400",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334986904",
            "telephone_number": "954-866-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20283 STATE ROAD 7 STE 400",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334986904",
            "telephone_number": "954-866-1430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2541 N Bouvier St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191323816",
            "country_code": "US",
            "telephone_number": "267-574-2457",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 E Sunrise Blvd # 4-705",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333042880",
            "country_code": "US",
            "telephone_number": "267-574-5457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANBACK",
        "first_name": "NIKEDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "outsidetheboxabaservices@gmail.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "20283 State Road 7 Ste 400",
            "city": "Boca Raton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334986904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.

Verify at the official NPI Registry.