Individual provider Active NPI

Rebecca Fire, BCBA

  • Behavior Analyst
  • Port St Lucie, FL
National Provider Identifier
1700335379
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11829899
Practice address
10850 S US Highway 1 Ste 2
Port St Lucie, FL 34952-6407
Phone
(772) 463-0444
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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 11829899 Primary
Other Technician 247200000X 1616794 FL

Addresses

Primary practice location

10850 S US Highway 1 Ste 2
Port St Lucie, FL 34952-6407

Mailing address

150 W University Blvd
The Scott Center
Melbourne, FL 32901-6982
Phone (321) 674-8106

Other practice location 1

150 W University Blvd
The Scott Center
Melbourne, FL 32901-6982
Phone (321) 674-8106

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

LicenseStateTypeSpecialty
1616794FLMDOther Technician

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1700335379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W UNIVERSITY BLVD",
            "address_2": "THE SCOTT CENTER",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329016982",
            "telephone_number": "321-674-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 S US HIGHWAY 1 STE 2",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349526407",
            "telephone_number": "772-463-0444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 W University Blvd",
            "address_2": "The Scott Center",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329016982",
            "country_code": "US",
            "telephone_number": "321-674-8106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIRE",
        "first_name": "REBECCA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "11829899",
            "primary": true
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "FL",
            "license": "1616794",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.