Active NPI
Patricia Miracle-Botley
- Behavior Analyst
- Voorhees, NJ
National Provider Identifier
1568044147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-49409
- Practice address
- 500 S Burnt Mill Rd
Voorhees, NJ 08043-2205 - Phone
- (888) 859-7749
- Fax
- (888) 859-7749
- NPI assigned
- Apr 23, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 Analyst | 103K00000X | 1-21-49409 | NJ | Primary |
Addresses
Primary practice location
500 S Burnt Mill Rd
Voorhees, NJ 08043-2205
Mailing address
83 Harding Ave
Oaklyn, NJ 08107-1530
Phone (856) 631-8102
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619136000000",
"number": "1568044147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "83 HARDING AVE",
"city": "OAKLYN",
"state": "NJ",
"postal_code": "081071530",
"telephone_number": "856-631-8102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 S BURNT MILL RD",
"city": "VOORHEES",
"state": "NJ",
"postal_code": "080432205",
"telephone_number": "888-859-7749",
"fax_number": "888-859-7749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRACLE-BOTLEY",
"first_name": "PATRICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-23",
"last_updated": "2021-04-23",
"certification_date": "2021-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": "NJ",
"license": "1-21-49409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Voorhees, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.