Deijah Wannamaker

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

2324 Younts Rd
Indian Trail, NC 28079-8507

Phone

(704) 893-3607

NPI assigned

Oct 24, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1801617535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7736 WATERFORD LAKES DRIVE",
            "address_2": "APARTMENT 1416",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28210",
            "telephone_number": "803-800-4954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 YOUNTS RD",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280798507",
            "telephone_number": "704-893-3607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16004 Harbor Hill Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282730163",
            "country_code": "US",
            "telephone_number": "704-593-9069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANNAMAKER",
        "first_name": "DEIJAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Indian Trail, NC
• Providers in Indian Trail, NC by specialty
• Behavior Technician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.