Individual provider Active NPI

Cammi Fendler

  • Behavior Analyst
  • Jacksonville, FL
National Provider Identifier
1578962908
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-73883 Issued in FL
Practice address
12724 Gran Bay Parkway West
Suite 410
Jacksonville, FL 32258-9486
Phone
(239) 745-1853
NPI assigned
Aug 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-24-73883 FL Primary

Addresses

Primary practice location

12724 Gran Bay Parkway West
Suite 410
Jacksonville, FL 32258-9486

Mailing address

13363 Currituck Dr N
Jacksonville, FL 32225-3352
Phone (239) 745-1853

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": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1578962908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13363 CURRITUCK DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253352",
            "telephone_number": "239-745-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12724 GRAN BAY PARKWAY WEST",
            "address_2": "SUITE 410",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322589486",
            "telephone_number": "239-745-1853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDLER",
        "first_name": "CAMMI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-24-73883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.