Individual provider Active NPI

Nicole H Santiago

  • Behavior Technician
  • Stuart, FL
National Provider Identifier
1790463149
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
850 NW Federal Hwy Ste 173
Stuart, FL 34994-1019
Phone
(772) 362-9878
Fax
(772) 362-9879
NPI assigned
Jul 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 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 FL Primary

Addresses

Primary practice location

850 NW Federal Hwy Ste 173
Stuart, FL 34994-1019

Mailing address

742 SW General Patton Ter
Port Saint Lucie, FL 34953-2656
Phone (772) 777-6166

Other practice location 1

13195 SW 134th St Ste 201
Miami, FL 33186-4585
Phone (786) 206-6500 ext. 120

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

Practice roles

OrganizationSpecialtyStatusNew patients
Weevolve, LLC PastSince Jan 12, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1790463149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "742 SW GENERAL PATTON TER",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349532656",
            "telephone_number": "772-777-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 NW FEDERAL HWY STE 173",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349941019",
            "telephone_number": "772-362-9878",
            "fax_number": "772-362-9879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13195 SW 134th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331864585",
            "country_code": "US",
            "telephone_number": "786-206-6500 x120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "NICOLE",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.