Active NPI
Kelsey Denise Isom, BCBA
- Behavior Analyst
- Saint Joseph, MO
National Provider Identifier
1043870660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2019032712
- Practice address
- 3213 Seneca St
Saint Joseph, MO 64507-2026 - Phone
- (816) 752-7501
- NPI assigned
- Jun 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Behavior Analyst | 103K00000X | 2019032712 | MO | Primary |
Addresses
Primary practice location
3213 Seneca St
Saint Joseph, MO 64507-2026
Mailing address
3213 Seneca St
Saint Joseph, MO 64507-2026
Phone (816) 752-7501
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 |
|---|---|---|---|
| 2019032712 | MO | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1043870660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3213 SENECA ST",
"city": "SAINT JOSEPH",
"state": "MO",
"postal_code": "645072026",
"telephone_number": "816-752-7501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3213 SENECA ST",
"city": "SAINT JOSEPH",
"state": "MO",
"postal_code": "645072026",
"telephone_number": "816-752-7501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISOM",
"first_name": "KELSEY",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-17",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MO",
"license": "2019032712",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Joseph, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.