Individual provider Active NPI

Rodney James Liles

  • Behavior Technician
  • Kennesaw, GA
National Provider Identifier
1790501351
Registry record updated Nov 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1806 Shiloh Valley CT NW
Kennesaw, GA 30144-3162
Phone
(678) 761-7701
NPI assigned
Nov 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 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

1806 Shiloh Valley CT NW
Kennesaw, GA 30144-3162

Mailing address

1806 Shiloh Valley CT NW
Kennesaw, GA 30144-3162
Phone (678) 761-7701

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": "1732752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732752000000",
    "number": "1790501351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 SHILOH VALLEY CT NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443162",
            "telephone_number": "678-761-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 SHILOH VALLEY CT NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443162",
            "telephone_number": "678-761-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILES",
        "first_name": "RODNEY",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-28",
        "last_updated": "2024-11-28",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.