Individual provider Active NPI

Sabrina Renea Ficklin

  • Behavior Technician
  • Ardmore, OK
National Provider Identifier
1609408897
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
M080989998 Issued in OK
Practice address
1021 8TH Ave NW
Ardmore, OK 73401-4015
Phone
(580) 220-0857
NPI assigned
Feb 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X M080989998 OK Primary

Addresses

Primary practice location

1021 8TH Ave NW
Ardmore, OK 73401-4015

Mailing address

1021 8TH Ave NW
Ardmore, OK 73401-4015
Phone (580) 220-0857

Other identifiers 1

IdentifierTypeStateIssuer
M080989998OtherOKSTATE OF OKLAHOMA

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
M080989998OKMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1609408897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 8TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734014015",
            "telephone_number": "580-220-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 8TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734014015",
            "telephone_number": "580-220-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FICKLIN",
        "first_name": "SABRINA",
        "middle_name": "RENEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "OK",
            "license": "M080989998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OKLAHOMA",
            "identifier": "M080989998",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.