Active NPI
Tavon Ross
- Behavior Technician
- Suitland, MD
National Provider Identifier
1891320495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 19-109227
- Practice address
- 3906 Regency Pkwy Apt 106
Suitland, MD 20746-2265 - Phone
- (301) 978-6832
- NPI assigned
- Mar 4, 2020
- 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 | 19-109227 | MD | Primary |
Addresses
Primary practice location
3906 Regency Pkwy Apt 106
Suitland, MD 20746-2265
Mailing address
3906 Regency Pkwy Apt 106
Suitland, MD 20746-2265
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19-109227 | MD | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583280000000",
"number": "1891320495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3906 REGENCY PKWY APT 106",
"city": "SUITLAND",
"state": "MD",
"postal_code": "207462265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3906 REGENCY PKWY APT 106",
"city": "SUITLAND",
"state": "MD",
"postal_code": "207462265",
"telephone_number": "301-978-6832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "TAVON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-04",
"last_updated": "2020-03-04",
"certification_date": "2020-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MD",
"license": "19-109227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suitland, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.