Active NPI
Dennis Dean Bledsoe Jr., LBA, BCBA
- Behavior Analyst
- Columbia, MO
National Provider Identifier
1073988069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2013009326
- Practice address
- 1506 Anthony St
Columbia, MO 65201-5806 - Phone
- (573) 499-1362
- Fax
- (573) 499-1362
- NPI assigned
- Dec 2, 2015
- Sex
- Male
- 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 | 2013009326 | MO | Primary |
Addresses
Primary practice location
1506 Anthony St
Columbia, MO 65201-5806
Mailing address
1506 Anthony St
Columbia, MO 65201-5806
Phone (573) 499-1362
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 |
|---|---|---|---|
| 2013009326 | MO | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bledsoe Professional Services | Behavior Analyst | Past | 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.
-
- Behavior Analyst
- Columbia, MO
- NPI 1205290145
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449014400000",
"number": "1073988069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1506 ANTHONY ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652015806",
"telephone_number": "573-499-1362",
"fax_number": "573-499-1362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1506 ANTHONY ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652015806",
"telephone_number": "573-499-1362",
"fax_number": "573-499-1362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLEDSOE",
"first_name": "DENNIS",
"middle_name": "DEAN",
"name_suffix": "Jr.",
"credential": "LBA, BCBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-02",
"last_updated": "2015-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MO",
"license": "2013009326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.