Active NPI
Timothy H Bulger III, BCBA
- Behavior Analyst
- Lauderdale Lakes, FL
National Provider Identifier
1649760968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-50416
- Practice address
- 4620 N State Road 7 Ste 300
Lauderdale Lakes, FL 33319-5867 - Phone
- (850) 218-2249
- NPI assigned
- May 11, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 18-55199 | FL | |
| Behavior Analyst | 103K00000X | 1-21-50416 | FL | Primary |
Addresses
Primary practice location
4620 N State Road 7 Ste 300
Lauderdale Lakes, FL 33319-5867
Mailing address
4620 N State Road 7 Ste 300
Lauderdale Lakes, FL 33319-5867
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-18-55199 | Other | FL | REGISTERED BEHAVIOR TECHNICIAN |
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 |
|---|---|---|---|
| 18-55199 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682899200000",
"number": "1649760968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4620 N STATE ROAD 7 STE 300",
"city": "LAUDERDALE LAKES",
"state": "FL",
"postal_code": "333195867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4620 N STATE ROAD 7 STE 300",
"city": "LAUDERDALE LAKES",
"state": "FL",
"postal_code": "333195867",
"telephone_number": "850-218-2249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BULGER",
"first_name": "TIMOTHY",
"middle_name": "H",
"name_suffix": "III",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-11",
"last_updated": "2023-05-01",
"certification_date": "2023-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "18-55199",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-21-50416",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED BEHAVIOR TECHNICIAN",
"identifier": "RBT-18-55199",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lauderdale Lakes, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.