Active NPI
Torianna Jabre Tucker
- Behavior Technician
- Pine Mountain, GA
National Provider Identifier
1801637996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-345214
- Practice address
- 140 Ebenezer Church Rd
Pine Mountain, GA 31822-5006 - Phone
- (706) 551-0362
- NPI assigned
- Jun 4, 2024
- 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 | RBT-24-345214 | GA | Primary |
Addresses
Primary practice location
140 Ebenezer Church Rd
Pine Mountain, GA 31822-5006
Mailing address
140 Ebenezer Church Rd
Pine Mountain, GA 31822-5006
Phone (706) 551-0362
Other names 1
- Torianna Fannin
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-24-345214 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1801637996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 EBENEZER CHURCH RD",
"city": "PINE MOUNTAIN",
"state": "GA",
"postal_code": "318225006",
"telephone_number": "706-551-0362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 EBENEZER CHURCH RD",
"city": "PINE MOUNTAIN",
"state": "GA",
"postal_code": "318225006",
"telephone_number": "706-551-0362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "TORIANNA",
"middle_name": "JABRE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-04",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-24-345214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TORIANNA",
"last_name": "FANNIN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Pine Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.