Active NPI
Diane Edwards
- Behavior Technician
- West Palm Beach, FL
National Provider Identifier
1972169555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 1984131
- Practice address
- 3203 Glenmoor Dr
West Palm Beach, FL 33409-2822 - Phone
- (954) 515-9722
- NPI assigned
- May 19, 2019
- Sex
- Female
- 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 | 1984131 | FL | Primary |
Addresses
Primary practice location
3203 Glenmoor Dr
West Palm Beach, FL 33409-2822
Mailing address
3203 Glenmoor Dr
West Palm Beach, FL 33409-2822
Phone (954) 515-9722
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1984131 | Other | FL | BACB |
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 |
|---|---|---|---|
| 1984131 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558224000000",
"number": "1972169555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3203 GLENMOOR DR",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334092822",
"telephone_number": "954-515-9722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3203 GLENMOOR DR",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334092822",
"telephone_number": "954-515-9722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "DIANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-19",
"last_updated": "2019-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "1984131",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB",
"identifier": "1984131",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.