Active NPI
Arianna Patricia Gomez
- Behavior Technician
- Grand Rapids, MI
National Provider Identifier
1659059558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- BACB962948
- Practice address
- 534 Eastern Ave NE
Grand Rapids, MI 49503-1809 - Phone
- (517) 480-4006
- NPI assigned
- Jul 10, 2023
- 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 | BACB962948 | MI | Primary |
Addresses
Primary practice location
534 Eastern Ave NE
Grand Rapids, MI 49503-1809
Mailing address
534 Eastern Ave NE
Grand Rapids, MI 49503-1809
Phone (517) 480-4006
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 |
|---|---|---|---|
| BACB962948 | MI | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1659059558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "534 EASTERN AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031809",
"telephone_number": "517-480-4006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "534 EASTERN AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031809",
"telephone_number": "517-480-4006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "ARIANNA",
"middle_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-10",
"last_updated": "2023-07-10",
"certification_date": "2023-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MI",
"license": "BACB962948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.