Individual provider Active NPI

Samantha Conaway

  • Behavior Analyst
  • Cookeville, TN
National Provider Identifier
1699305763
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-66538 Issued in FL
Practice address
206 S Jefferson Ave
Cookeville, TN 38501-4748
Phone
(931) 283-2919
NPI assigned
Jan 17, 2020
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Technician 106S00000X FL
Behavior Analyst 103K00000X 1-23-66538 FL Primary

Addresses

Primary practice location

206 S Jefferson Ave
Cookeville, TN 38501-4748

Mailing address

1500 S Douglas Rd Ste 230
Coral Gables, FL 33134-4108
Phone (844) 854-1116

Other practice location 1

500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817
Phone (877) 418-2978

Other practice location 2

21600 Oxnard St
Woodland Hills, CA 91367-4976
Phone (818) 345-2345

Other practice location 3

815 S Parsons Ave
Brandon, FL 33511-6063
Phone (941) 263-1451

Other practice location 4

1500 S Douglas Rd Ste 230
Coral Gables, FL 33134-4108
Phone (844) 854-1116

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

OrganizationSpecialtyStatusNew patients
Mobile Therapy Center of America, LLC Past Accepting new patients
Acorn Health, LLC. Behavior Analyst Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1699305763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLAS RD STE 230",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344108",
            "telephone_number": "844-854-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S JEFFERSON AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014748",
            "telephone_number": "931-283-2919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Fairway Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334411817",
            "country_code": "US",
            "telephone_number": "877-418-2978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21600 Oxnard St",
            "address_purpose": "LOCATION",
            "city": "Woodland Hills",
            "state": "CA",
            "postal_code": "913674976",
            "country_code": "US",
            "telephone_number": "818-345-2345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "815 S Parsons Ave",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335116063",
            "country_code": "US",
            "telephone_number": "941-263-1451",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 S Douglas Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331344108",
            "country_code": "US",
            "telephone_number": "844-854-1116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONAWAY",
        "first_name": "SAMANTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-17",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-23-66538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.