Active NPI
Blaine Stiglets, RBT
- Behavior Technician
- Gulfport, MS
National Provider Identifier
1700492592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-134263
- Practice address
- 15489 Dedeaux Rd
Gulfport, MS 39503-2667 - Phone
- (228) 357-5671
- NPI assigned
- Sep 17, 2020
- Last updated
- Sep 17, 2020
- Sex
- Male
- 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-20-134263 | MS | Primary |
Addresses
Primary practice location
15489 Dedeaux Rd
Gulfport, MS 39503-2667
Mailing address
2417 22ND Ave
Gulfport, MS 39501-4624
Phone (228) 380-0355
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-20-134263 | MS | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gulf Coast Education Solutions | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600300800000",
"number": "1700492592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2417 22ND AVE",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395014624",
"telephone_number": "228-380-0355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15489 DEDEAUX RD",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395032667",
"telephone_number": "228-357-5671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIGLETS",
"first_name": "BLAINE",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-17",
"last_updated": "2020-09-17",
"certification_date": "2020-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MS",
"license": "RBT-20-134263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.