Active NPI
Jessica Moreno, RBT
- Behavior Technician
- Gardendale, AL
National Provider Identifier
1801645536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-330768
- Practice address
- 2244 North Rd Ste 116
Gardendale, AL 35071-2258 - Phone
- (659) 207-6622
- Fax
- (317) 520-8200
- NPI assigned
- May 15, 2024
- Sex
- Female
- Sole proprietor
- No
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-24-330768 | AL | Primary |
Addresses
Primary practice location
2244 North Rd Ste 116
Gardendale, AL 35071-2258
Mailing address
200 Vestavia Pkwy Ste 2400
Vestavia, AL 35216-3797
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-24-330768 | AL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735344000000",
"number": "1801645536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 VESTAVIA PKWY STE 2400",
"city": "VESTAVIA",
"state": "AL",
"postal_code": "352163797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2244 NORTH RD STE 116",
"city": "GARDENDALE",
"state": "AL",
"postal_code": "350712258",
"telephone_number": "659-207-6622",
"fax_number": "317-520-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "JESSICA",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-15",
"last_updated": "2024-12-28",
"certification_date": "2024-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "AL",
"license": "RBT-24-330768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardendale, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.