Active NPI
Samantha Jean Forsythe
- Behavior Technician
- La Vista, NE
National Provider Identifier
1821820374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-24-367940
- Practice address
- 10717 Virginia PLZ Ste 113
La Vista, NE 68128-3255 - Phone
- (402) 926-4373
- NPI assigned
- Aug 14, 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-24-367940 | NE | Primary |
Addresses
Primary practice location
10717 Virginia PLZ Ste 113
La Vista, NE 68128-3255
Mailing address
1214 Applewood Dr Apt F206
Papillion, NE 68046-7631
Phone (314) 504-9878
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-24-367940 | NE | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behaven Kids, LLC | Behavior Technician | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723593600000",
"number": "1821820374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1214 APPLEWOOD DR APT F206",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680467631",
"telephone_number": "314-504-9878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10717 VIRGINIA PLZ STE 113",
"city": "LA VISTA",
"state": "NE",
"postal_code": "681283255",
"telephone_number": "402-926-4373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORSYTHE",
"first_name": "SAMANTHA",
"middle_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-14",
"last_updated": "2024-08-14",
"certification_date": "2024-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NE",
"license": "RBT-24-367940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Vista, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.