Individual provider Active NPI

Ingrid L Mercedes

  • Behavior Technician
  • Deland, FL
National Provider Identifier
1609362086
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-18-56762 Issued in FL
Practice address
920 Hunters Creek Dr Apt 5303
Deland, FL 32720-0978
Phone
(561) 800-6734
NPI assigned
Jul 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 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 RBT-18-56762 FL Primary

Addresses

Primary practice location

920 Hunters Creek Dr Apt 5303
Deland, FL 32720-0978

Mailing address

920 Hunters Creek Dr Apt 5303
Deland, FL 32720-0978
Phone (561) 800-6734

Other practice location 1

1310 NW 44th St
Miami, FL 33142-7925
Phone (786) 659-6517

Other identifiers 1

IdentifierTypeStateIssuer
020891800MedicaidFL

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
RBT-18-56762FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1609362086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 HUNTERS CREEK DR APT 5303",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327200978",
            "telephone_number": "561-800-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 HUNTERS CREEK DR APT 5303",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327200978",
            "telephone_number": "561-800-6734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 NW 44th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331427925",
            "country_code": "US",
            "telephone_number": "786-659-6517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERCEDES",
        "first_name": "INGRID",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-09",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-18-56762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020891800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.