Amy Jo Blair, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-34840 Issued in NU

Practice address

925 Dudley Pike
Edgewood, KY 41017-8120

Phone

(859) 360-3006

Fax

(859) 360-3053

NPI assigned

Sep 10, 2019

Last updated

Sep 10, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bluegrass Behavioral Health Group, LLC

  dba Cultivate Behavioral Health and Education

  • Behavior Analyst
  • Edgewood, KY
  • NPI 1952840860
  NPD

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1023667284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 DUDLEY PIKE",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410178120",
            "telephone_number": "859-360-3006",
            "fax_number": "859-360-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 DUDLEY PIKE",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410178120",
            "telephone_number": "859-360-3006",
            "fax_number": "859-360-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "AMY JO",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-19-34840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952840860",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Nicole Bischof, CRNA
• Stephanie Marie Bishop, P.T.
• Suzanne M Black
• Monica Blackburn, CRNA
• William Joseph Blackburn, PT
• Julie Blair, PT
• Flynn Charles Blanchet, MD
• Kristie L Blanchet
• Brittany Jean Blankenship, APRN
• April Bleecker, RBT

• Behavior Analyst in Edgewood, KY
• Providers in Edgewood, KY by specialty
• Behavior Analyst in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.