Active NPI
Tyler Gillmor
- Behavior Technician
- Cameron Park, CA
National Provider Identifier
1831689017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 3222 Royal Dr Ste Z
Cameron Park, CA 95682-8556 - Phone
- (530) 387-7544
- Fax
- (530) 677-5443
- NPI assigned
- May 14, 2018
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
3222 Royal Dr Ste Z
Cameron Park, CA 95682-8556
Mailing address
PO Box 2000
Shingle Springs, CA 95682-2000
Phone (530) 387-7544
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 1St Step Applied Behavior Analysts, Inc. | Past | Accepting new patients | |
| 1St Step Applied Behavior Analysts, Inc | 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.
-
- Community/Behavioral Health Agency
- Cameron Park, CA
- NPI 1689912032
-
- Behavior Analyst
- Cameron Park, CA
- NPI 1053770461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526256000000",
"number": "1831689017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2000",
"city": "SHINGLE SPRINGS",
"state": "CA",
"postal_code": "956822000",
"telephone_number": "530-387-7544",
"fax_number": "530-677-5443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3222 ROYAL DR STE Z",
"city": "CAMERON PARK",
"state": "CA",
"postal_code": "956828556",
"telephone_number": "530-387-7544",
"fax_number": "530-677-5443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLMOR",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-14",
"last_updated": "2018-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cameron Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.