Individual provider Active NPI

Alexis Mariah Verdon

  • Behavior Analyst
  • Orlando, FL
National Provider Identifier
1861921769
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-20-40633 Issued in FL
Practice address
12780 Waterford Lakes Pkwy Ste 127
Orlando, FL 32828-4501
Phone
(941) 932-0322
NPI assigned
Jun 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-20-40633 FL Primary

Addresses

Primary practice location

12780 Waterford Lakes Pkwy Ste 127
Orlando, FL 32828-4501

Mailing address

12780 Waterford Lakes Pkwy Ste 127
Orlando, FL 32828-4501
Phone (941) 932-0322

Other practice location 1

10426 Chorlton Cir
Orlando, FL 32832-6168
Phone (941) 932-0322

Other practice location 2

2218 Mahan Dr
Tallahassee, FL 32308-6127
Phone (850) 320-6555

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

OrganizationSpecialtyStatusNew patients
ABA Family Therapy LLC Behavior Analyst CurrentSince Nov 29, 2020 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": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1861921769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12780 WATERFORD LAKES PKWY STE 127",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284501",
            "telephone_number": "941-932-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12780 WATERFORD LAKES PKWY STE 127",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328284501",
            "telephone_number": "941-932-0322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10426 Chorlton Cir",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328326168",
            "country_code": "US",
            "telephone_number": "941-932-0322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2218 Mahan Dr",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323086127",
            "country_code": "US",
            "telephone_number": "850-320-6555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERDON",
        "first_name": "ALEXIS",
        "middle_name": "MARIAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-20-40633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.