Individual provider Active NPI

Paola Rodriguez, RBT

  • Behavior Technician
  • Fort Collins, CO
National Provider Identifier
1558029009
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB719050 Issued in CO
Practice address
3351 Eastbrook Dr Ste 101
Fort Collins, CO 80525-5744
Phone
(970) 698-8980
NPI assigned
Dec 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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 BACB719050 CO Primary

Addresses

Primary practice location

3351 Eastbrook Dr Ste 101
Fort Collins, CO 80525-5744

Mailing address

4470 S Lemay Ave Apt 805
Fort Collins, CO 80525-4833
Phone (720) 934-8910

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Desktop Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
BACB719050COMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1558029009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4470 S LEMAY AVE APT 805",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254833",
            "telephone_number": "720-934-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 EASTBROOK DR STE 101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255744",
            "telephone_number": "970-698-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "PAOLA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CO",
            "license": "BACB719050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Desktop",
            "affiliation": "N",
            "endpointDescription": "A platform that is only accessible by other health care providers to communicate with one another. as well as patients",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3351 Eastbrook Dr Ste 101",
            "city": "Fort Collins",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805255744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.

Verify at the official NPI Registry.