Active NPI
Kelsey Burgess
- Behavior Technician
- Charlotte, NC
National Provider Identifier
1003305863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-16-20941
- Practice address
- 2301 Crownpoint Executive Dr Ste E
Charlotte, NC 28227-6725 - Phone
- (704) 708-8314
- Fax
- (704) 708-8315
- NPI assigned
- May 8, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | RBT-16-20941 | SC | Primary |
Addresses
Primary practice location
2301 Crownpoint Executive Dr Ste E
Charlotte, NC 28227-6725
Mailing address
2301 Crownpoint Executive Dr Ste E
Charlotte, NC 28227-6725
Phone (704) 708-8314
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 |
|---|---|---|---|
| RBT-16-20941 | SC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525737600000",
"number": "1003305863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 CROWNPOINT EXECUTIVE DR STE E",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282276725",
"telephone_number": "704-708-8314",
"fax_number": "704-708-8315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 CROWNPOINT EXECUTIVE DR STE E",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282276725",
"telephone_number": "704-708-8314",
"fax_number": "704-708-8315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURGESS",
"first_name": "KELSEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-08",
"last_updated": "2018-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "SC",
"license": "RBT-16-20941",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.