Individual provider Active NPI

Medjine Duver

  • Behavior Technician
  • Ellisville, MO
National Provider Identifier
1508773631
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
333 Ozark Trail Dr
Ellisville, MO 63011-2169
Phone
(636) 398-2500
Fax
(800) 687-5070
NPI assigned
Aug 25, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 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

333 Ozark Trail Dr
Ellisville, MO 63011-2169

Mailing address

4721 S Cliff Ave Ste 103
Independence, MO 64055-6969
Phone (816) 608-1956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1508773631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 S CLIFF AVE STE 103",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556969",
            "telephone_number": "816-608-1956",
            "fax_number": "800-687-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 OZARK TRAIL DR",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112169",
            "telephone_number": "636-398-2500",
            "fax_number": "800-687-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVER",
        "first_name": "MEDJINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellisville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.