Active NPI
Chantall Samantha Green
- Behavior Technician
- Kissimmee, FL
National Provider Identifier
1508530627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3831 W Vine St Ste 60
Kissimmee, FL 34741-4650 - Phone
- (407) 559-4854
- NPI assigned
- Aug 3, 2021
- 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 | Primary |
Addresses
Primary practice location
3831 W Vine St Ste 60
Kissimmee, FL 34741-4650
Mailing address
300 Montana Ave
Saint Cloud, FL 34769-2668
Phone (407) 655-6609
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infinity Behavior LLC | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627948800000",
"number": "1508530627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 MONTANA AVE",
"city": "SAINT CLOUD",
"state": "FL",
"postal_code": "347692668",
"telephone_number": "407-655-6609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3831 W VINE ST STE 60",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347414650",
"telephone_number": "407-559-4854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "CHANTALL",
"middle_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-03",
"last_updated": "2021-08-03",
"certification_date": "2021-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.