Active NPI
Crysta Nadien Goodman, RBT
- Behavior Technician
- Fayetteville, NC
National Provider Identifier
1740704279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 5948 Fisher Rd
Fayetteville, NC 28304-5640 - Phone
- (910) 401-2870
- NPI assigned
- Jul 26, 2017
- Last updated
- Jul 26, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | NC | Primary |
Addresses
Primary practice location
5948 Fisher Rd
Fayetteville, NC 28304-5640
Mailing address
111 Mackenan Dr
Cary, NC 27511-7903
Phone (919) 371-2848
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501027200000",
"number": "1740704279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 MACKENAN DR",
"city": "CARY",
"state": "NC",
"postal_code": "275117903",
"telephone_number": "919-371-2848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5948 FISHER RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283045640",
"telephone_number": "910-401-2870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "CRYSTA",
"middle_name": "NADIEN",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-26",
"last_updated": "2017-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NC",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.