NPIMap

Organization Active NPI

Farm Creek

  • Behavior Analyst
  • Stafford, VA
National Provider Identifier
1083335608
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
FARM CREEK
Practice address
190 Cherry Hill Dr Apt Suite
Stafford, VA 22556-3654
Phone
(831) 334-0248
NPI assigned
Sep 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Melanie Kells, BCBANPI 1275900383
Title
Owner
Phone
(831) 334-0248

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

190 Cherry Hill Dr Apt Suite
Stafford, VA 22556-3654

Mailing address

190 Cherry Hill Dr Apt Suite
Stafford, VA 22556-3654
Phone (831) 334-0248

Other identifiers 1

IdentifierTypeStateIssuer
1275900383MedicaidVA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1083335608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 CHERRY HILL DR APT SUITE",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225563654",
            "telephone_number": "831-334-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CHERRY HILL DR APT SUITE",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225563654",
            "telephone_number": "831-334-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARM CREEK",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "KELLS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "831-334-0248",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275900383",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.