Individual provider Active NPI

Ayanna Ammons

  • Behavior Technician
  • Jacksonville, FL
National Provider Identifier
1639042906
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-472247 Issued in FL
Practice address
10886 Cabbage Pond CT
Jacksonville, FL 32257-3396
Phone
(904) 491-2111
NPI assigned
Sep 24, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-25-472247 FL Primary

Addresses

Primary practice location

10886 Cabbage Pond CT
Jacksonville, FL 32257-3396

Mailing address

13121 Atlantic Blvd Ste 200
Jacksonville, FL 32225-0102
Phone (904) 491-2111

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-25-472247FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Life Skills LLC PastSince Sep 28, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1758672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1639042906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13121 ATLANTIC BLVD STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322250102",
            "telephone_number": "904-491-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10886 CABBAGE POND CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322573396",
            "telephone_number": "904-491-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMONS",
        "first_name": "AYANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-24",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-25-472247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; 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.