Individual provider Active NPI

Marie Regalbuto

  • Behavior Analyst
  • Charlotte, NC
National Provider Identifier
1982160305
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-18-33806 Issued in NC
Practice address
2810 Coliseum Centre Dr Ste 520
Charlotte, NC 28217-3345
Phone
(980) 785-1113
Fax
(000) 000-0000
NPI assigned
Feb 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 152 NC
Behavior Analyst 103K00000X
Behavior Analyst 103K00000X 1-18-33806 NY
Behavior Analyst 103K00000X 1-18-33806 NC Primary

Addresses

Primary practice location

2810 Coliseum Centre Dr Ste 520
Charlotte, NC 28217-3345

Mailing address

2810 Coliseum Centre Dr Ste 520
Charlotte, NC 28217-3345

Other practice location 1

2301 Energy Dr Bldg 9
Apex, NC 27502-4343
Phone (501) 574-3053 ext. 00000

Other practice location 2

6 Forest Ave
Paramus, NJ 07652-5241
Phone (551) 245-9090

Other practice location 3

6 Forest Ave
Paramus, NJ 07652-5241
Phone (551) 245-9090

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

LicenseStateTypeSpecialty
152NCMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Group, LLC Behavior Analyst CurrentSince Apr 14, 2024 Accepting new patients

Locations

2810 Coliseum Centre Dr
Ste 520
Charlotte, NC 28217

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": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1982160305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 COLISEUM CENTRE DR STE 520",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173345",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 COLISEUM CENTRE DR STE 520",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282173345",
            "telephone_number": "980-785-1113",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Energy Dr Bldg 9",
            "address_purpose": "LOCATION",
            "city": "Apex",
            "state": "NC",
            "postal_code": "275024343",
            "country_code": "US",
            "telephone_number": "501-574-3053 x00000",
            "fax_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076525241",
            "country_code": "US",
            "telephone_number": "551-245-9090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076525241",
            "country_code": "US",
            "telephone_number": "551-245-9090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REGALBUTO",
        "first_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "152",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1-18-33806",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "1-18-33806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.