Annie Goodfellow, BS, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-19-105988 Issued in FL

Practice address

6789 Southpoint Pkwy Ste 100
Jacksonville, FL 32216-8205

Phone

(904) 379-6045

Fax

(904) 301-4741

NPI assigned

Nov 14, 2019

Last updated

Nov 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Growing Together ABA

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1992474944

  Behavior Technician

  NPD

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1619512571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6789 SOUTHPOINT PKWY STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168205",
            "telephone_number": "904-379-6045",
            "fax_number": "904-301-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6789 SOUTHPOINT PKWY STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168205",
            "telephone_number": "904-379-6045",
            "fax_number": "904-301-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODFELLOW",
        "first_name": "ANNIE",
        "credential": "BS, RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-19-105988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Diane Goodbread, CNA
• Bridgid Marie Goode, LMT
• Margaret K Goode, REGISTERED INTERN
• Fiona Veronica Goodell, CCC-SLP
• Robert Whitney Goodell
• Marlene S Goodfriend, MD
• Steven Goodfriend, MD
• Carl Robert Goodholm Jr., LCSW
• Dawn Cass Goodholm, REGISTERED DIETITIAN
• Kenneth M Goodin, DPT

• Behavior Technician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.