Individual provider Active NPI

Foeke Rienks, M.S. , BCBA

  • Behavior Analyst
  • Jacksonville, FL
National Provider Identifier
1700113735
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-16577 Issued in FL
Practice address
8011 Philips Hwy Ste 10
Jacksonville, FL 32256-7459
Phone
(904) 928-0112
Fax
(904) 647-9489
NPI assigned
Nov 12, 2009
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 0-08-2622 FL
Behavior Analyst 103K00000X 1-14-16577 FL Primary

Addresses

Primary practice location

8011 Philips Hwy Ste 10
Jacksonville, FL 32256-7459

Mailing address

8011 Philips Hwy Ste 10
Jacksonville, FL 32256-7459
Phone (904) 612-4524

Other practice location 1

10175 Fortune Pkwy Unit 903
Jacksonville, FL 32256-6755
Phone (904) 538-0713

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1700113735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8011 PHILIPS HWY STE 10",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567459",
            "telephone_number": "904-612-4524",
            "fax_number": "904-647-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8011 PHILIPS HWY STE 10",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567459",
            "telephone_number": "904-928-0112",
            "fax_number": "904-647-9489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10175 Fortune Pkwy Unit 903",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322566755",
            "country_code": "US",
            "telephone_number": "904-538-0713",
            "fax_number": "904-538-0714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIENKS",
        "first_name": "FOEKE",
        "credential": "M.S. , BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-12",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "0-08-2622",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-14-16577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.