Active NPI
Taaji Bolton, RBT
- Behavior Technician
- Champaign, IL
National Provider Identifier
1851970404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 19-97902
- Practice address
- 4112 Fieldstone Rd
Suite B
Champaign, IL 61822-6182 - Phone
- (888) 308-3728
- NPI assigned
- Apr 2, 2021
- 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 | 19-97902 | Primary |
Addresses
Primary practice location
4112 Fieldstone Rd
Suite B
Champaign, IL 61822-6182
Mailing address
245 W Roosevelt Rd
West Chicago, IL 60185-3739
Phone (888) 308-3728
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617321600000",
"number": "1851970404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 W ROOSEVELT RD",
"city": "WEST CHICAGO",
"state": "IL",
"postal_code": "601853739",
"telephone_number": "888-308-3728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4112 FIELDSTONE RD",
"address_2": "SUITE B",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618226182",
"telephone_number": "888-308-3728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTON",
"first_name": "TAAJI",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-02",
"last_updated": "2021-04-02",
"certification_date": "2021-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": "19-97902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.