Active NPI
Mark Redoway
- Behavior Technician
- Melbourne, FL
National Provider Identifier
1750865325
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 150 W University Blvd
Melbourne, FL 32901-6975 - Phone
- (321) 674-8106
- NPI assigned
- Sep 19, 2018
- 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 | Primary |
Addresses
Primary practice location
150 W University Blvd
Melbourne, FL 32901-6975
Mailing address
907 Palm Springs Blvd Apt B
Indian Harbour Beach, FL 32937-2665
Phone (330) 261-1879
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": "1537315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1750865325",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 PALM SPRINGS BLVD APT B",
"city": "INDIAN HARBOUR BEACH",
"state": "FL",
"postal_code": "329372665",
"telephone_number": "330-261-1879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 W UNIVERSITY BLVD",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329016975",
"telephone_number": "321-674-8106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDOWAY",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-19",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"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 Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.