Active NPI
Samantha Bass, RBT
- Behavior Technician
- Gulf Breeze, FL
National Provider Identifier
1689206310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3208 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3350 - Phone
- (800) 676-5130
- NPI assigned
- Feb 11, 2020
- 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 | Primary |
Addresses
Primary practice location
3208 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3350
Mailing address
3208 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3350
Phone (800) 676-5130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B200-792-79-685-0 | Other | FL | DRIVER'S LICENSE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vivid Behavior Solutions | Current | 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.
-
- Behavior Analyst
- Gulf Breeze, FL
- NPI 1528995685
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581379200000",
"number": "1689206310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3208 GULF BREEZE PKWY",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325633350",
"telephone_number": "800-676-5130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3208 GULF BREEZE PKWY",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325633350",
"telephone_number": "800-676-5130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASS",
"first_name": "SAMANTHA",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-11",
"last_updated": "2020-02-11",
"certification_date": "2020-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "B200-792-79-685-0",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.