Individual provider Active NPI

Bethany Lewis Cotton

  • Behavior Technician
  • Jacksonville, FL
National Provider Identifier
1598234247
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618
Phone
(904) 886-3228
Fax
(904) 485-8876
NPI assigned
Nov 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 Primary

Addresses

Primary practice location

12276 San Jose Blvd Ste 508
Jacksonville, FL 32223-8618

Mailing address

10263 Whispering Forest Dr Apt 1017
Jacksonville, FL 32257-8638
Phone (904) 208-0697

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": "1542931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1598234247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10263 WHISPERING FOREST DR APT 1017",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578638",
            "telephone_number": "904-208-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12276 SAN JOSE BLVD STE 508",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238618",
            "telephone_number": "904-886-3228",
            "fax_number": "904-485-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTON",
        "first_name": "BETHANY",
        "middle_name": "LEWIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-23",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "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 Jul 21, 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.

Verify at the official NPI Registry.