Amber Leigh Smith

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-23-66230 Issued in FL

Practice address

171 Canal Blvd
Ponte Vedra Beach, FL 32082-3607

Phone

(904) 834-7581

NPI assigned

Jan 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Mandala Family Wellness LLC

  • Occupational Therapist
  • Ponte Vedra Beach, FL
  • NPI 1063296754
  NPD
• Mandala Family Wellness LLC

  • Psychologist
  • Ponte Vedra Beach, FL
  • NPI 1497262620
  NPD (past)

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

{
    "created_epoch": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1629618228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 CANAL BLVD",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823607",
            "telephone_number": "904-834-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 CANAL BLVD",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823607",
            "telephone_number": "904-834-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "AMBER",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-23-66230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sleep Doctor Medical Group of New Jersey, P.C.
• Sleep Doctor Medical Group of Oregon, P.C.
• Sleep Doctor Medical Group PA
• Sleep Medicine Ny Practice, P.C.
• Olivia Ann Smerdon
• Cynthia Smith, M.A, CCC-SLP
• Eryn Doppke Smith, FNP- C
• Jeanette Goates Smith, L.M.F.T.
• Robert Gregory Smith, MD
• William Douglas Smith, O.D.

• Behavior Analyst in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; 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.