NPIMap

Organization Active NPI

Developmental Wellness

  • Behavior Analyst
  • Pella, IA
National Provider Identifier
1063971166
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
DEVELOPMENTAL WELLNESS
Practice address
910 Washington St
Pella, IA 50219-1504
Phone
(515) 664-3244
Fax
(844) 519-7713
NPI assigned
Mar 18, 2019
Last updated
Aug 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Authorized official

Name
Kyle Cervone, BCBANPI 1174868699
Title
Owner/Chief Clinical Officer
Phone
(515) 664-3422

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

910 Washington St
Pella, IA 50219-1504

Mailing address

4912 Walker Cir
Johnston, IA 50131-2535
Phone (515) 664-3244

National Provider Directory

National Provider Directory

Locations

910 Washington St
Pella, IA 50219
Phone (515) 664-3244

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1063971166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4912 WALKER CIR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312535",
            "telephone_number": "515-664-3244",
            "fax_number": "844-519-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WASHINGTON ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191504",
            "telephone_number": "515-664-3244",
            "fax_number": "844-519-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "CERVONE",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER/CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "515-664-3422",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.