Active NPI
Taytum Goodman
- Behavior Technician
- Port Saint Lucie, FL
National Provider Identifier
1619770104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB1018502
- Practice address
- 1801 SE Hillmoor Dr Ste B101-103
Port Saint Lucie, FL 34952-7553 - Phone
- (830) 377-9721
- NPI assigned
- Mar 31, 2025
- 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 Technician | 106S00000X | BACB1018502 | TX | Primary |
Addresses
Primary practice location
1801 SE Hillmoor Dr Ste B101-103
Port Saint Lucie, FL 34952-7553
Mailing address
2424 Metfield Dr Apt 2410
Melbourne, FL 32940-5324
Phone (830) 377-9721
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
| License | State | Type | Specialty |
|---|---|---|---|
| BACB1018502 | TX | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767484800000",
"number": "1619770104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2424 METFIELD DR APT 2410",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329405324",
"telephone_number": "830-377-9721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 SE HILLMOOR DR STE B101-103",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349527553",
"telephone_number": "830-377-9721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "TAYTUM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-31",
"last_updated": "2026-01-04",
"certification_date": "2026-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "TX",
"license": "BACB1018502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.