Active NPI
Justin Carter
- Behavior Technician
- Fort Walton Beach, FL
National Provider Identifier
1992411953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 23-254050
- Practice address
- 106 Chicago Ave SE Apt 2
Fort Walton Beach, FL 32548-7277 - Phone
- (803) 770-8510
- NPI assigned
- Jan 24, 2023
- 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 | 23-254050 | FL | Primary |
Addresses
Primary practice location
106 Chicago Ave SE Apt 2
Fort Walton Beach, FL 32548-7277
Mailing address
106 Chicago Ave SE Apt 2
Fort Walton Beach, FL 32548-7277
Phone (803) 770-8510
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 |
|---|---|---|---|
| 23-254050 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674604800000",
"number": "1992411953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 CHICAGO AVE SE APT 2",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325487277",
"telephone_number": "803-770-8510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 CHICAGO AVE SE APT 2",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325487277",
"telephone_number": "803-770-8510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-24",
"last_updated": "2023-01-25",
"certification_date": "2023-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "23-254050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.