Individual provider Active NPI

Nicole Norris, BCBA

  • Behavior Analyst
  • Colorado Springs, CO
National Provider Identifier
1083023048
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-23177 Issued in CO
Practice address
5446 N Academy Blvd Ste 204
Colorado Springs, CO 80918-3669
Phone
(719) 598-5555
NPI assigned
Aug 4, 2014
Last updated
Oct 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X K01857652 KS
Behavior Analyst 103K00000X 1-16-23177 CO Primary

Addresses

Primary practice location

5446 N Academy Blvd Ste 204
Colorado Springs, CO 80918-3669

Mailing address

5446 N Academy Blvd Ste 205
Colorado Springs, CO 80918-3669
Phone (719) 598-5555

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

LicenseStateTypeSpecialty
K01857652KSMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Wellcare Inc. Behavior Analyst CurrentSince Jan 5, 2020 Accepting new patients
Nurture Home Health Care Inc PastSince Jun 1, 2020 Accepting new patients

Locations

5446 N Academy Blvd
Ste 204
Colorado Springs, CO 80918
Phone (719) 400-7612

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1083023048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD STE 205",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183669",
            "telephone_number": "719-598-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5446 N ACADEMY BLVD STE 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183669",
            "telephone_number": "719-598-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "NICOLE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KS",
            "license": "K01857652",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "1-16-23177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.

Verify at the official NPI Registry.