Active NPI
Amanda Hanie
- Behavior Technician
- Jacksonville, FL
National Provider Identifier
1669128518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-22-205112
- Practice address
- 10175 Fortune Pkwy Unit 802
Jacksonville, FL 32256-6754 - Phone
- (912) 785-9027
- NPI assigned
- Mar 1, 2022
- 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 | RBT-22-205112 | FL | Primary |
Addresses
Primary practice location
10175 Fortune Pkwy Unit 802
Jacksonville, FL 32256-6754
Mailing address
PO Box 253
Skillman, NJ 08558-0253
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 |
|---|---|---|---|
| RBT-22-205112 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exceptional Kidz Rehabilitation | Behavior Technician | Past | 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.
-
- Speech-Language Pathologist
- Pemberton, NJ
- NPI 1467738492
Behavior Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1646092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646092800000",
"number": "1669128518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 253",
"city": "SKILLMAN",
"state": "NJ",
"postal_code": "085580253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10175 FORTUNE PKWY UNIT 802",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322566754",
"telephone_number": "912-785-9027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANIE",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-01",
"last_updated": "2022-03-01",
"certification_date": "2022-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-22-205112",
"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 Mar 1, 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.