BETHANY MOORE (NPI# 1336645738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336645738 |
| Entity Type | Individual |
| Full Name | BETHANY MOORE |
| Practice Address |
3766 Us Highway 17 Ste 301 Richmond Hill GA 31324-8876 |
| Mailing Address |
10175 Fortune Pkwy Unit 903 Jacksonville FL 32256-6755 |
| Practice Telephone | 9127560656 |
| Mailing Telephone | 9045380713 |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | RBT-18-52562 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134401003 | Bethany B Moore | Pharmacist | 3416 Lake Arrowhead Dr, Harvey, LA 70058-5533 | 2011-09-15 |
| 1215208038 | Bethany Moore | Occupational Therapist | 2628 N Fraser St, Georgetown, SC 29440-6946 | 2012-01-25 |
| 1144501958 | Bethany Renee Moore | Registered Nurse | 5891 Route 21, Williamson, NY 14589-9102 | 2011-09-07 |
| Street Address |
3766 US HIGHWAY 17 STE 301 |
| City | RICHMOND HILL |
| State | GA |
| Zip Code | 31324-8876 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982944815 | Belinda M Montelbano | Behavioral Analyst | 3766 Us Highway 17 Ste 301, Richmond Hill, GA 31324-8876 | 2013-03-01 |
| 1043867138 | Kali Brux | Behavior Technician | 3766 Us Highway 17 Ste 301, Richmond Hill, GA 31324-8876 | 2019-08-22 |
| 1689228082 | Timothy Sellers | Behavior Technician | 3766 Us Highway 17 Ste 301, Richmond Hill, GA 31324-8876 | 2019-07-25 |
| 1881250280 | Brooke Gold | Behavior Technician | 3766 Us Highway 17 Ste 301, Richmond Hill, GA 31324-8876 | 2019-05-13 |
| 1679034037 | Carly Moore | Behavior Technician | 3766 Us Highway 17 Ste 301, Richmond Hill, GA 31324 | 2019-03-28 |
| 1558821330 | Jessica Barr | Behavior Technician | 3766 Us Highway 17 Ste 301, Richmond Hill, GA 31324-8876 | 2019-03-20 |
| 1619440807 | Matelean Anderson | Behavior Technician | 3766 Us Highway 17 Ste 301, Richmond Hill, GA 31324-8876 | 2019-01-10 |
| 1407338346 | Whitley Martin | Behavior Technician | 3766 Us Highway 17 Ste 301, Richmond Hill, GA 31324-8876 | 2018-09-06 |
| 1548742323 | Ashanti Unaka | Behavior Technician | 3766 Us Highway 17 Ste 301, Richmond Hill, GA 31324-8876 | 2018-08-29 |
| 1639661242 | Jillian Kemp | Behavior Technician | 3766 Us Highway 17 Ste 301, Richmond Hill, GA 31324-8876 | 2018-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902389588 | Bryan Anderson | Physician Assistant | 8435 Vanguard Road, Fort Stewart, GA 31324 | 2018-09-10 |
| 1366941684 | Codie Wiley | Physician Assistant | Expercare Urgent Care 60 Exchange Street, Suite B7, Richmond Hill, GA 31324 | 2018-02-02 |
| 1174038145 | Shelly Stewart Childers | Nurse Practitioner | 2453 U.S. 17, Suite G, Richmond Hill, GA 31324 | 2017-12-12 |
| 1619495215 | Kristi Oxley | Nurse Practitioner | 2701 Us Hwy 17 Ste 1b, Richmond Hill, GA 31324 | 2017-09-03 |
| 1275062564 | Janice Tillman Gravitt | Registered Nurse | 60 Long Creek Lane, Richmond Hill, GA 31324 | 2017-06-08 |
| 1336680065 | Choice Care Medical | Durable Medical Equipment & Medical Supplies | 9390 Ford Ave Ste 9, Richmond Hill, GA 31324 | 2017-03-14 |
| 1750730263 | Haralabos Saltourides | Physical Therapy Assistant | 127 Carter Street, Richmond Hill, GA 31324 | 2016-06-06 |
| 1922462464 | Leia Edenfield | Student in an Organized Health Care Education/Training Program | 105 Balfour Dr, Richmond Hill, GA 31324 | 2016-04-11 |
| 1477931384 | Stephanie Eileen Banasik | Nurse Practitioner | 10200 Ford Ave. Ste. 101, Richmond Hill, GA 31324 | 2015-05-12 |
| 1962800771 | Kendra Seagraves | Nurse Practitioner | 9976 Ford Avenue, Richmond Hill, GA 31324 | 2014-12-10 |
| Find all providers in zip 31324 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578176525 | Samantha Gosper | Behavior Technician | 194 Ainsdale Dr, Richmond Hill, GA 31324-7821 | 2020-08-28 |
| 1841802998 | Jacquan White | Behavior Technician | 100 Timber Trail Rd Ste 100, Richmond Hill, GA 31324-9415 | 2020-08-20 |
| 1346874047 | Nicollette Hendley | Behavior Technician | 100 Timber Trail, Suite 201, Richmond Hill, GA 31324-9430 | 2020-03-03 |
| 1417589136 | Brandy Lee Hill | Behavior Technician | 10 Long Creek Lane, Richmond Hill, GA 31324-8601 | 2020-02-11 |
| 1205470960 | Kylie E Mccollough | Behavior Technician | 100 Timber Trail Rd Ste 201, Richmond Hill, GA 31324-9430 | 2019-11-05 |
| 1831661693 | Allyson Leigh Sierra | Behavior Technician | 3766 Highway 17 Suite 301, Richmond Hill, GA 31324-3132 | 2018-12-18 |
| 1457828550 | Audrea Katina Espinoza | Behavior Technician | 88 William Hall Way, Richmond Hill, GA 31324-5933 | 2018-10-26 |
| 1447725957 | Megan Elizabeth Wallace | Behavior Technician | 784 Kelsall Dr, Richmond Hill, GA 31324-7706 | 2018-10-11 |
| 1700487337 | Tabitha Hayden | Behavior Technician | 100 Timber Trail Rd Ste 201, Richmond Hill, GA 31324-9430 | 2020-11-02 |
| 1881201663 | Kenya D Rose | Behavior Technician | 10 Long Creek Ln, Richmond Hill, GA 31324-8601 | 2020-09-25 |
| Find all providers in RICHMOND HILL | ||||
| City | RICHMOND HILL |
| Zip Code | 31324 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.