Active NPI
Christina Ruth Ennis, BCBA
- Behavior Analyst
- Gainesville, FL
National Provider Identifier
1609126119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-14-9563
- Practice address
- 9200 NW 39TH Ave
Suite 130-1020
Gainesville, FL 32606-3260 - Phone
- (855) 832-6727
- Fax
- (772) 675-9100
- NPI assigned
- Sep 12, 2012
- Last updated
- Feb 9, 2021
- Sex
- Female
- 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 Analyst | 103K00000X | 1-14-9563 | Primary |
Addresses
Primary practice location
9200 NW 39TH Ave
Suite 130-1020
Gainesville, FL 32606-3260
Mailing address
7108 South Kramer Hwy.
Stuart, FL 34997-7462
Phone (855) 832-6727
Other practice location 1
12271 Lexington Park Dr Apt 207
Tampa, FL 33626-2737
Phone (407) 463-6414
Other practice location 2
11236 NW 34th Ave
Gainesville, FL 32606-6806
Phone (407) 463-6414
Other practice location 3
1842 Jaclif Ct
Tallahassee, FL 32308-4400
Phone (850) 298-8862
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": "1347408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612828800000",
"number": "1609126119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 SOUTH KRAMER HWY.",
"city": "STUART",
"state": "FL",
"postal_code": "349977462",
"telephone_number": "855-832-6727",
"fax_number": "772-675-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9200 NW 39TH AVE",
"address_2": "SUITE 130-1020",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326063260",
"telephone_number": "855-832-6727",
"fax_number": "772-675-9100"
}
],
"practiceLocations": [
{
"address_1": "12271 Lexington Park Dr Apt 207",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336262737",
"country_code": "US",
"telephone_number": "407-463-6414",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11236 NW 34th Ave",
"address_purpose": "LOCATION",
"city": "Gainesville",
"state": "FL",
"postal_code": "326066806",
"country_code": "US",
"telephone_number": "407-463-6414",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1842 Jaclif Ct",
"address_purpose": "LOCATION",
"city": "Tallahassee",
"state": "FL",
"postal_code": "323084400",
"country_code": "US",
"telephone_number": "850-298-8862",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ENNIS",
"first_name": "CHRISTINA",
"middle_name": "RUTH",
"name_prefix": "Mrs.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-12",
"last_updated": "2021-02-09",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-14-9563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.