Active NPI
Omari Jackson
- Behavior Technician
- Miramar, FL
National Provider Identifier
1669214383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-352907
- Practice address
- 9221 S Cypress Cir
Miramar, FL 33025-2458 - Phone
- (954) 632-6043
- NPI assigned
- Jun 12, 2024
- Sex
- Male
- Sole proprietor
- Yes
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-24-352907 | FL | Primary |
Addresses
Primary practice location
9221 S Cypress Cir
Miramar, FL 33025-2458
Mailing address
9221 S Cypress Cir
Miramar, FL 33025-2458
Phone (954) 632-6043
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-24-352907 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Awc Behavioral Health LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Boca Raton, FL
- NPI 1669103875
Behavior Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1669214383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9221 S CYPRESS CIR",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330252458",
"telephone_number": "954-632-6043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9221 S CYPRESS CIR",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330252458",
"telephone_number": "954-632-6043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "OMARI",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-12",
"last_updated": "2024-06-14",
"certification_date": "2024-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-24-352907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.