Active NPI
Benjamin Noah Guadalupe
- Behavior Technician
- Dayton, OH
National Provider Identifier
1780456715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-306131
- Practice address
- 4134 Linden Ave
Dayton, OH 45432-3043 - Phone
- (937) 365-7455
- Fax
- (937) 600-6071
- NPI assigned
- Oct 24, 2023
- 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 | RBT-23-306131 | OH | Primary |
Addresses
Primary practice location
4134 Linden Ave
Dayton, OH 45432-3043
Mailing address
1628 E Dorothy LN
Kettering, OH 45429-3810
Phone (937) 750-8236
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-23-306131 | OH | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698105600000",
"number": "1780456715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1628 E DOROTHY LN",
"city": "KETTERING",
"state": "OH",
"postal_code": "454293810",
"telephone_number": "937-750-8236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4134 LINDEN AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454323043",
"telephone_number": "937-365-7455",
"fax_number": "937-600-6071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUADALUPE",
"first_name": "BENJAMIN",
"middle_name": "NOAH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-24",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "OH",
"license": "RBT-23-306131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.