Active NPI
Reagan Rae McCray
- Behavior Technician
- Melbourne, FL
National Provider Identifier
1750849014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-348270
- Practice address
- 504 Gardenia Dr
Melbourne, FL 32901-1408 - Phone
- (321) 830-4086
- NPI assigned
- Mar 6, 2019
- Reactivated
- Jul 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-348270 | FL | Primary |
| Social Worker | 104100000X |
Addresses
Primary practice location
504 Gardenia Dr
Melbourne, FL 32901-1408
Mailing address
13355 W Colonial Dr
Winter Garden, FL 34787-3970
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-24-348270 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1750849014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13355 W COLONIAL DR",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347873970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 GARDENIA DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329011408",
"telephone_number": "321-830-4086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCRAY",
"first_name": "REAGAN",
"middle_name": "RAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-06",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"deactivation_date": "2024-05-20",
"reactivation_date": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-24-348270",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.