Active NPI
Jordan Forre
- Behavior Technician
- Fort Lauderdale, FL
National Provider Identifier
1669957957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-18-73691
- Practice address
- 2601 NE 37TH Dr
Fort Lauderdale, FL 33308-6324 - Phone
- (954) 294-4651
- NPI assigned
- Oct 2, 2018
- 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-18-73691 | FL | Primary |
Addresses
Primary practice location
2601 NE 37TH Dr
Fort Lauderdale, FL 33308-6324
Mailing address
2601 NE 37TH Dr
Fort Lauderdale, FL 33308-6324
Phone (954) 294-4651
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 021814500 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-18-73691 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562457600000",
"number": "1669957957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 NE 37TH DR",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333086324",
"telephone_number": "954-294-4651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 NE 37TH DR",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333086324",
"telephone_number": "954-294-4651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORRE",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-02",
"last_updated": "2019-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-18-73691",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "021814500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.