Active NPI
Michelle Kim, BCBA
- Behavior Analyst
- Palm Bay, FL
National Provider Identifier
1023300464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 0-10-3932
- Practice address
- 3556 Plume Way SE
Palm Bay, FL 32909 - Phone
- (321) 626-1083
- NPI assigned
- May 4, 2011
- 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 Analyst | 103K00000X | 0-10-3932 | FL | Primary |
Addresses
Primary practice location
3556 Plume Way SE
Palm Bay, FL 32909
Mailing address
PO Box 230
Grant, FL 32949
Phone (321) 626-1083
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339977600000",
"number": "1023300464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 230",
"city": "GRANT",
"state": "FL",
"postal_code": "32949",
"telephone_number": "321-626-1083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3556 PLUME WAY SE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "32909",
"telephone_number": "321-626-1083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MICHELLE",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-04",
"last_updated": "2012-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "0-10-3932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.