Active NPI
Kevon Gibbs
- Behavior Technician
- Orlando, FL
National Provider Identifier
1538816681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 21-177502
- Practice address
- 6101 Chancellor Dr
Orlando, FL 32809-5698 - Phone
- (407) 205-9735
- NPI assigned
- Mar 8, 2022
- Last updated
- Mar 8, 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 | 21-177502 | FL | Primary |
Addresses
Primary practice location
6101 Chancellor Dr
Orlando, FL 32809-5698
Mailing address
304 Autumn Breeze Way
Winter Park, FL 32792-3906
Phone (786) 291-3330
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 |
|---|---|---|---|
| 21-177502 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646697600000",
"number": "1538816681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 AUTUMN BREEZE WAY",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327923906",
"telephone_number": "786-291-3330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6101 CHANCELLOR DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328095698",
"telephone_number": "407-205-9735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "KEVON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-08",
"last_updated": "2022-03-08",
"certification_date": "2022-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "21-177502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.