Individual provider Active NPI

Qwenton Gude, RBT

  • Behavior Technician
  • Tampa, FL
National Provider Identifier
1629505151
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-19-77677 Issued in IL
Practice address
8001 Beaty Grove Dr
Tampa, FL 33626-1602
Phone
(813) 403-0993
NPI assigned
May 15, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-19-77677 IL Primary
Community Health Worker 172V00000X

Addresses

Primary practice location

8001 Beaty Grove Dr
Tampa, FL 33626-1602

Mailing address

8001 Beaty Grove Dr
Tampa, FL 33626-1602
Phone (813) 403-0993

Other practice location 1

30630 Latourette Dr
Wesley Chapel, FL 33545-7012
Phone (217) 706-1529

Other practice location 2

1234 Rivage Cir
Brandon, FL 33511-3702
Phone (813) 403-0993

Other identifiers 1

IdentifierTypeStateIssuer
G300711964190MedicaidFL

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-19-77677ILMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1629505151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 BEATY GROVE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261602",
            "telephone_number": "813-403-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 BEATY GROVE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261602",
            "telephone_number": "813-403-0993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30630 Latourette Dr",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335457012",
            "country_code": "US",
            "telephone_number": "217-706-1529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1234 Rivage Cir",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335113702",
            "country_code": "US",
            "telephone_number": "813-403-0993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUDE",
        "first_name": "QWENTON",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-15",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IL",
            "license": "RBT-19-77677",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G300711964190",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.