Individual provider Active NPI

Matthew Taylor Womack

  • Behavior Technician
  • Oak Park, MI
National Provider Identifier
1750142006
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
10730 Albany St
Oak Park, MI 48237-3907
Phone
(313) 428-7667
NPI assigned
Jan 23, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

10730 Albany St
Oak Park, MI 48237-3907

Mailing address

10730 Albany St
Oak Park, MI 48237-3907
Phone (313) 428-7667

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": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1750142006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10730 ALBANY ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373907",
            "telephone_number": "313-428-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10730 ALBANY ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373907",
            "telephone_number": "313-428-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "MATTHEW",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.