Active NPI
Nikesha Frederick
- Behavior Technician
- Casselberry, FL
National Provider Identifier
1801480132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 21-157717
- Practice address
- 148 Wilshire Blvd
Casselberry, FL 32707-5372 - Phone
- (132) 197-2403
- NPI assigned
- Feb 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 21-157717 | FL | Primary |
Addresses
Primary practice location
148 Wilshire Blvd
Casselberry, FL 32707-5372
Mailing address
148 Wilshire Blvd
Casselberry, FL 32707-5372
Phone (132) 197-2403
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lsantiago@camenbehavioral.org |
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 |
|---|---|---|---|
| 21-157717 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bumblebee ABA Inc | Past | 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": "1614297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614297600000",
"number": "1801480132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 WILSHIRE BLVD",
"city": "CASSELBERRY",
"state": "FL",
"postal_code": "327075372",
"telephone_number": "132-197-2403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 WILSHIRE BLVD",
"city": "CASSELBERRY",
"state": "FL",
"postal_code": "327075372",
"telephone_number": "132-197-2403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "NIKESHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-26",
"last_updated": "2021-02-26",
"certification_date": "2021-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "21-157717",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lsantiago@camenbehavioral.org",
"affiliation": "N",
"address_1": "148 Wilshire Blvd",
"city": "Casselberry",
"state": "FL",
"country_code": "US",
"postal_code": "327075372",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Casselberry, FL
- Florida Foot & Ankle Group PA
- Christine Mary Forge, PMHNP
- Grace Forty
- Carl Frank Foster
- Aimee N Fowler, APRN
- Fresenius Medical Care Casselberry, LLC (Fresenius Kidney Care Casselberry)
- Fringe Counseling Collective
- Fyziotherapy (Rehability Physical Therapy)
- Gaia Holistic Primary Care LLC
- Laura S Galan II
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.