Kaylon Mims Carpenter

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2017-123 Issued in AL

Practice address

7026 Southgate Dr SE
Owens Cross Roads, AL 35763-9289

Phone

(205) 862-3365

NPI assigned

Aug 22, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1003196098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7026 SOUTHGATE DR SE",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "357639289",
            "telephone_number": "205-862-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7026 SOUTHGATE DR SE",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "357639289",
            "telephone_number": "205-862-3365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Cardinal Dr Unit 103",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402131379",
            "country_code": "US",
            "telephone_number": "205-862-3365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "KAYLON",
        "middle_name": "MIMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AL",
            "license": "2017-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Owens Cross Roads, AL
• Providers in Owens Cross Roads, AL by specialty
• Behavior Analyst in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.