Active NPI
Dylan Marks
- Behavior Analyst
- Phoenix, AZ
National Provider Identifier
1689137309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 9300015
- Practice address
- 1117 E Beryl Ave
Phoenix, AZ 85020-1539 - Phone
- (480) 292-1211
- NPI assigned
- Apr 9, 2019
- 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 Analyst | 103K00000X | 9300015 | AZ | Primary |
Addresses
Primary practice location
1117 E Beryl Ave
Phoenix, AZ 85020-1539
Mailing address
1117 E Beryl Ave
Phoenix, AZ 85020-1539
Phone (480) 292-1211
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 |
|---|---|---|---|
| 9300015 | AZ | MD | Behavioral Analyst |
Interoperability endpoints
- carla.mitchell.p1@direct.anewleaf.nextgenshare.com
- dylan.marks.p1@direct.anewleaf.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554768000000",
"number": "1689137309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1117 E BERYL AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850201539",
"telephone_number": "480-292-1211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1117 E BERYL AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850201539",
"telephone_number": "480-292-1211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "DYLAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-09",
"last_updated": "2019-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AZ",
"license": "9300015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.