Active NPI
Lynnique Pettis, RBT CERTIFIED
- Behavior Technician
- Hickory, NC
National Provider Identifier
1871306985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 16 2ND St NW
Hickory, NC 28601-6105 - Phone
- (828) 358-0976
- NPI assigned
- Jan 31, 2025
- Sex
- Female
- Sole proprietor
- Yes
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
16 2ND St NW
Hickory, NC 28601-6105
Mailing address
2675 Court Dr
Gastonia, NC 28054-1478
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 |
|---|---|---|---|
| Complete Rehabilitation and Sports Physical Therapy, PC | Past | Accepting new patients | |
| Comprehab LLC | Behavior Technician | 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.
-
- Physical Therapist
- Ronkonkoma, NY
- NPI 1811097306
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738281600000",
"number": "1871306985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2675 COURT DR",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280541478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 2ND ST NW",
"city": "HICKORY",
"state": "NC",
"postal_code": "286016105",
"telephone_number": "828-358-0976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIS",
"first_name": "LYNNIQUE",
"credential": "RBT CERTIFIED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-31",
"last_updated": "2025-01-31",
"certification_date": "2025-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hickory, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.