Individual provider Active NPI

Audrey Buchanan

  • Behavior Analyst
  • Boerne, TX
National Provider Identifier
1043875875
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
4936 Issued in TX
Practice address
101 Pine View Dr
Boerne, TX 78006-8842
Phone
(830) 816-5510
Fax
(855) 421-1717
NPI assigned
May 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 4936 TX Primary

Addresses

Primary practice location

101 Pine View Dr
Boerne, TX 78006-8842

Mailing address

101 Pine View Dr
Boerne, TX 78006-8842
Phone (830) 816-5510

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mindscapes Behavioral Health Behavior Analyst CurrentSince Dec 6, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1043875875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PINE VIEW DR",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068842",
            "telephone_number": "830-816-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PINE VIEW DR",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068842",
            "telephone_number": "830-816-5510",
            "fax_number": "855-421-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "AUDREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "4936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.