Active NPI
John A Bozek, RBT
- Behavior Technician
- Fairfax, VA
National Provider Identifier
1952926040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 542068
- Practice address
- 11200 Waples Mill Rd
Fairfax, VA 22030-7407 - Phone
- (703) 237-2219
- NPI assigned
- Jun 15, 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 | 542068 | VA | Primary |
Addresses
Primary practice location
11200 Waples Mill Rd
Fairfax, VA 22030-7407
Mailing address
11200 Waples Mill Rd
Fairfax, VA 22030-7407
Phone (703) 237-2219
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 |
|---|---|---|---|
| 542068 | VA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Axiom Link, Inc. | Behavior Technician | Past | 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": "1592179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592179200000",
"number": "1952926040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11200 WAPLES MILL RD",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220307407",
"telephone_number": "703-237-2219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11200 WAPLES MILL RD",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220307407",
"telephone_number": "703-237-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOZEK",
"first_name": "JOHN",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-15",
"last_updated": "2020-06-15",
"certification_date": "2020-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "542068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.