Individual provider Active NPI

Whitney Vonshea Dickens, BACHELORS

  • Behavior Technician
  • Ocala, FL
National Provider Identifier
1679001127
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
18-62535 Issued in FL
Practice address
3850 W Anthony Rd
Ocala, FL 34475
Phone
(321) 241-1170
Fax
(321) 241-1171
NPI assigned
May 30, 2017
Last updated
Aug 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 18-62535 FL Primary

Addresses

Primary practice location

3850 W Anthony Rd
Ocala, FL 34475

Mailing address

2128 Simmons Ave
Leesburg, FL 34748-3797
Phone (407) 492-4107

Other practice location 1

16414 Lake Church Dr
Odessa, FL 33556-2637
Phone (813) 926-5656

Other identifiers 1

IdentifierTypeStateIssuer
017475600MedicaidFL

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

LicenseStateTypeSpecialty
18-62535FLMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1679001127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2128 SIMMONS AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483797",
            "telephone_number": "407-492-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 W ANTHONY RD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34475",
            "telephone_number": "321-241-1170",
            "fax_number": "321-241-1171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16414 Lake Church Dr",
            "address_purpose": "LOCATION",
            "city": "Odessa",
            "state": "FL",
            "postal_code": "335562637",
            "country_code": "US",
            "telephone_number": "813-926-5656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DICKENS",
        "first_name": "WHITNEY",
        "middle_name": "VONSHEA",
        "name_prefix": "Ms.",
        "credential": "BACHELORS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "18-62535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017475600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.