Brennon Dantzler-Campbell, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-23-254833 Issued in GA

Practice address

3766 US Highway 17 Ste 301
Richmond Hill, GA 31324-8876

Phone

(904) 538-0713

Fax

(904) 538-0714

NPI assigned

Jan 23, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1740995935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY UNIT 903",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566755",
            "telephone_number": "904-538-0713",
            "fax_number": "904-538-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3766 US HIGHWAY 17 STE 301",
            "city": "RICHMOND HILL",
            "state": "GA",
            "postal_code": "313248876",
            "telephone_number": "904-538-0713",
            "fax_number": "904-538-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANTZLER-CAMPBELL",
        "first_name": "BRENNON",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-23-254833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Caleb Davis, LMT, PTA
• Jackee Davis
• Lexy Sierra Davis
• Nathaniel Jeffery Davis
• Emerson Day

• Behavior Technician in Richmond Hill, GA
• Providers in Richmond Hill, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.