Active NPI
Taylor Jeffery, RBT
- Behavior Technician
- Orlando, FL
National Provider Identifier
1639694102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 644 Ferguson Dr Ste 200
Orlando, FL 32805-1023 - Phone
- (407) 574-4629
- NPI assigned
- Aug 7, 2017
- 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 | FL | Primary |
Addresses
Primary practice location
644 Ferguson Dr Ste 200
Orlando, FL 32805-1023
Mailing address
2553 Galliano Cir
Winter Park, FL 32792-1513
Phone (772) 418-6972
Other practice location 1
500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817
Phone (888) 880-9270
Other practice location 2
2553 Galliano Cir
Winter Park, FL 32792-1513
Phone (772) 418-6972
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102165200 | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1639694102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2553 GALLIANO CIR",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327921513",
"telephone_number": "772-418-6972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "644 FERGUSON DR STE 200",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328051023",
"telephone_number": "407-574-4629"
}
],
"practiceLocations": [
{
"address_1": "500 Fairway Dr Ste 102",
"address_purpose": "LOCATION",
"city": "Deerfield Beach",
"state": "FL",
"postal_code": "334411817",
"country_code": "US",
"telephone_number": "888-880-9270",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2553 Galliano Cir",
"address_purpose": "LOCATION",
"city": "Winter Park",
"state": "FL",
"postal_code": "327921513",
"country_code": "US",
"telephone_number": "772-418-6972",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JEFFERY",
"first_name": "TAYLOR",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-07",
"last_updated": "2022-07-21",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102165200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.