Individual provider Active NPI

Odalix Carrillo-Britt, RBT

  • Behavior Technician
  • Johnson City, TN
National Provider Identifier
1861192676
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
22-220914 Issued in CA
Practice address
321 W Walnut St Ste 2
Johnson City, TN 37604-6774
Phone
(423) 202-3622
NPI assigned
Mar 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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 22-220914 CA Primary

Addresses

Primary practice location

321 W Walnut St Ste 2
Johnson City, TN 37604-6774

Mailing address

321 W Walnut St Ste 2
Johnson City, TN 37604-6774
Phone (423) 202-3622

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
22-220914CAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1861192676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W WALNUT ST STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046774",
            "telephone_number": "423-202-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W WALNUT ST STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046774",
            "telephone_number": "423-202-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO-BRITT",
        "first_name": "ODALIX",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "22-220914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.