MEDICARE: JOHNNIE B SCAIFE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1598690752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHNNIE B SCAIFE

Provider Business Mailing Address
First Line	:	5963 KENTSHIRE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45440-4253
Country	:	US
Telephone Number	:	937-952-6379
Fax Number	:

Provider Business Practice Location Address
First Line	:	2840 E FLAMINGO RD STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5201
Country	:	US
Telephone Number	:	937-952-6379
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2026
Last Update Date	:	06/17/2026

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Directions to “ JOHNNIE B SCAIFE ” Practice Location

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