Active NPI
Samantha Elizabeth Ellis, RBT
- Behavior Technician
- Riverview, FL
National Provider Identifier
1629809462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-369108
- Practice address
- 4015 Crescent Park Dr
Riverview, FL 33578-3605 - Phone
- (813) 492-8310
- NPI assigned
- Aug 13, 2024
- 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 | RBT-24-369108 | IN | Primary |
Addresses
Primary practice location
4015 Crescent Park Dr
Riverview, FL 33578-3605
Mailing address
2119 Delightful Dr
Ruskin, FL 33570-5825
Phone (813) 285-6494
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 |
|---|---|---|---|
| RBT-24-369108 | IN | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reach High Consulting and Therapy, LLC | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Bloomington, IN
- NPI 1053629246
Behavior Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783641600000",
"number": "1629809462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2119 DELIGHTFUL DR",
"city": "RUSKIN",
"state": "FL",
"postal_code": "335705825",
"telephone_number": "813-285-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4015 CRESCENT PARK DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335783605",
"telephone_number": "813-492-8310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "SAMANTHA",
"middle_name": "ELIZABETH",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-13",
"last_updated": "2026-07-10",
"certification_date": "2026-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "IN",
"license": "RBT-24-369108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.