Marquita Randolph-Breeden

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

5816 Creedmoor Road, Suite 104
Raleigh, NC 27612

Phone

(919) 665-4673

NPI assigned

Jun 8, 2017

Last updated

Jun 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lukes ABA

  • Behavior Technician
  • Zebulon, NC
  • NPI 1306461439
  NPD Authorized official

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1811426109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5816 CREEDMOOR RD STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5816 CREEDMOOR ROAD, SUITE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27612",
            "telephone_number": "919-665-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH-BREEDEN",
        "first_name": "MARQUITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Baxter Waddill Rand, CRNA
• Carey Lovica Randall, MT-BC
• Dianne Denise Randall
• Felicia Randall
• Randi Wolk Occupational Therapy Services, PLLC
• Taffany Randolph
• Jitender Singh Rangar, M.D.
• Ananya Ranjan
• Kristin Nicole Rankin, M.S., M.A., OTR/L
• Donna Ransom, CRNA

• Behavior Technician in Raleigh, NC
• Providers in Raleigh, 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 Jun 15, 2020; 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.