Individual provider Active NPI

Adrienne Mitchell, RBT

  • Behavior Technician
  • Memphis, TN
National Provider Identifier
1821650698
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-19-82273 Issued in TN
Practice address
6413 Quince Rd
Memphis, TN 38119-8219
Phone
(901) 690-5213
Fax
(901) 666-8440
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-19-82273 TN Primary

Addresses

Primary practice location

6413 Quince Rd
Memphis, TN 38119-8219

Mailing address

6413 Quince Rd
Memphis, TN 38119-8219
Phone (901) 690-5213

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

LicenseStateTypeSpecialty
RBT-19-82273TNMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
The Seed Program Past Accepting new patients
Julie Demarco,Bcba Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1821650698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6413 QUINCE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381198219",
            "telephone_number": "901-690-5213",
            "fax_number": "901-666-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6413 QUINCE RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381198219",
            "telephone_number": "901-690-5213",
            "fax_number": "901-666-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ADRIENNE",
        "name_prefix": "Ms.",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TN",
            "license": "RBT-19-82273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.