Active NPI
Kristen Amber Connors, RBT
- Behavior Technician
- Palm Bay, FL
National Provider Identifier
1992282073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 17-28215
- Practice address
- 1320 Culver Dr NE
Palm Bay, FL 32907-1104 - Phone
- (321) 914-4055
- Fax
- (321) 473-8829
- NPI assigned
- Jul 23, 2018
- 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 | 17-28215 | SC | Primary |
Addresses
Primary practice location
1320 Culver Dr NE
Palm Bay, FL 32907-1104
Mailing address
1320 Culver Dr NE
Palm Bay, FL 32907-1104
Phone (321) 914-4055
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 |
|---|---|---|---|
| 17-28215 | SC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1992282073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 CULVER DR NE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329071104",
"telephone_number": "321-914-4055",
"fax_number": "321-473-8829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 CULVER DR NE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329071104",
"telephone_number": "321-914-4055",
"fax_number": "321-473-8829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNORS",
"first_name": "KRISTEN",
"middle_name": "AMBER",
"credential": "RBT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-23",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "SC",
"license": "17-28215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.