Active NPI
Traci Matthews
- Behavior Technician
- Stuart, FL
National Provider Identifier
1689212722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-19-85612
- Practice address
- 7108 S Kanner Hwy
Stuart, FL 34997-7462 - Phone
- (855) 832-6727
- NPI assigned
- Dec 19, 2019
- 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 | RBT-19-85612 | GA | Primary |
Addresses
Primary practice location
7108 S Kanner Hwy
Stuart, FL 34997-7462
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Phone (855) 832-6727
Other practice location 1
4000 Smithtown Rd Ste 200
Suwanee, GA 30024-6560
Phone (470) 632-4990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-19-85612 | Other | GA | RBT CERTIFICATE |
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-19-85612 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585526400000",
"number": "1689212722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462",
"telephone_number": "855-832-6727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [
{
"address_1": "4000 Smithtown Rd Ste 200",
"address_purpose": "LOCATION",
"city": "Suwanee",
"state": "GA",
"postal_code": "300246560",
"country_code": "US",
"telephone_number": "470-632-4990",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MATTHEWS",
"first_name": "TRACI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-19",
"last_updated": "2020-03-30",
"certification_date": "2020-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-19-85612",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RBT CERTIFICATE",
"identifier": "RBT-19-85612",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stuart, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.