Active NPI
Ryan Hodges
- Behavior Technician
- Johnston, IA
National Provider Identifier
1518682012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-21-156609
- Practice address
- 4912 Walker Cir
Johnston, IA 50131-2535 - Phone
- (515) 664-3422
- NPI assigned
- Oct 6, 2022
- Sex
- Male
- 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-21-156609 | IA | Primary |
Addresses
Primary practice location
4912 Walker Cir
Johnston, IA 50131-2535
Mailing address
8247 Villa Dr
Des Moines, IA 50320-6971
Phone (515) 554-7540
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-21-156609 | IA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Developmental Wellness | 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.
-
- Behavior Analyst
- Pella, IA
- NPI 1063971166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665014400000",
"number": "1518682012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8247 VILLA DR",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503206971",
"telephone_number": "515-554-7540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4912 WALKER CIR",
"city": "JOHNSTON",
"state": "IA",
"postal_code": "501312535",
"telephone_number": "515-664-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGES",
"first_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-06",
"last_updated": "2022-10-06",
"certification_date": "2022-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IA",
"license": "RBT-21-156609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnston, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.