Active NPI
Devyn Peabody
- Behavior Technician
- Port Richey, FL
National Provider Identifier
1821603796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-20-134166
- Practice address
- 9405 Barnstead LN
Port Richey, FL 34668-4302 - Phone
- (727) 967-2809
- NPI assigned
- Sep 9, 2020
- 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-20-134166 | FL | Primary |
Addresses
Primary practice location
9405 Barnstead LN
Port Richey, FL 34668-4302
Mailing address
5 Revere Dr Ste 120
Northbrook, IL 60062-8005
Phone (003) 564-0498
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107980100 | Medicaid | FL |
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-20-134166 | FL | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Divino ABA Services, LLC | 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.
-
- Behavior Analyst
- Port Richey, FL
- NPI 1124510227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647302400000",
"number": "1821603796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 REVERE DR STE 120",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600628005",
"telephone_number": "003-564-0498",
"fax_number": "941-485-0519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9405 BARNSTEAD LN",
"city": "PORT RICHEY",
"state": "FL",
"postal_code": "346684302",
"telephone_number": "727-967-2809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEABODY",
"first_name": "DEVYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-09",
"last_updated": "2022-03-15",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-20-134166",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "107980100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Richey, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.