Individual provider Active NPI

Ahjanae Momperousse

  • Behavior Technician
  • Melbourne, FL
National Provider Identifier
1487594479
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
410 N Wickham Rd
Melbourne, FL 32935-8648
Phone
(321) 622-6884
NPI assigned
Mar 30, 2026
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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 Primary

Addresses

Primary practice location

410 N Wickham Rd
Melbourne, FL 32935-8648

Mailing address

410 N Wickham Rd
Melbourne, FL 32935-8648

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

NPI Registry JSON

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

{
    "created_epoch": "1774828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1487594479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358648",
            "telephone_number": "321-622-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOMPEROUSSE",
        "first_name": "AHJANAE",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-03-30",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.