Individual provider Active NPI

Taylor Paige Tadlock

  • Assistant Behavior Analyst
  • Spring Lake, NC
National Provider Identifier
1639634868
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
License
RBT-19-77043 Issued in NC
Practice address
1018 N Bragg Blvd
Spring Lake, NC 28390-3316
Phone
(910) 295-2609
NPI assigned
Feb 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X RBT-19-77043 NC Primary

Addresses

Primary practice location

1018 N Bragg Blvd
Spring Lake, NC 28390-3316

Mailing address

1018 N Bragg Blvd
Spring Lake, NC 28390-3316

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-19-77043NCMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1639634868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 N BRAGG BLVD",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283903316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 N BRAGG BLVD",
            "city": "SPRING LAKE",
            "state": "NC",
            "postal_code": "283903316",
            "telephone_number": "910-295-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADLOCK",
        "first_name": "TAYLOR",
        "middle_name": "PAIGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NC",
            "license": "RBT-19-77043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.