NPIMap

Organization Active NPI

Ignite the Stars Behavioral Innovations, LLC

  • Behavior Analyst
  • Georgetown, KY
National Provider Identifier
1083458335
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
IGNITE THE STARS BEHAVIORAL INNOVATIONS, LLC
Practice address
861 Rogers Gap Rd
Georgetown, KY 40324-8935
Phone
(859) 229-1328
NPI assigned
Jun 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Authorized official

Name
Sara C Wilson, BCBA, LBANPI 1770240236
Title
Owner
Phone
(859) 229-1328

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Assistant Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 106E00000X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X

Addresses

Primary practice location

861 Rogers Gap Rd
Georgetown, KY 40324-8935

Mailing address

861 Rogers Gap Rd
Georgetown, KY 40324-8935
Phone (859) 229-1328

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": "1718928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718928000000",
    "number": "1083458335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 ROGERS GAP RD",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248935",
            "telephone_number": "859-229-1328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 ROGERS GAP RD",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403248935",
            "telephone_number": "859-229-1328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE THE STARS BEHAVIORAL INNOVATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-229-1328",
        "authorized_official_credential": "BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.