Active NPI
David Ebhomielen
- Behavior Technician
- Houston, TX
National Provider Identifier
1982162830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 15703 Longenbaugh Dr
Suite H
Houston, TX 77095-1605 - Phone
- (303) 989-8169
- NPI assigned
- Mar 11, 2019
- 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 | Primary |
Addresses
Primary practice location
15703 Longenbaugh Dr
Suite H
Houston, TX 77095-1605
Mailing address
15703 Longenbaugh Dr
Suite H
Houston, TX 77095-1605
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240523001274 | GA | Order and Referring Only - Internal Medicine | 4082056973 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576454400000",
"number": "1982162830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15703 LONGENBAUGH DR",
"address_2": "SUITE H",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770951605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15703 LONGENBAUGH DR",
"address_2": "SUITE H",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770951605",
"telephone_number": "303-989-8169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBHOMIELEN",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-11",
"last_updated": "2019-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.