Active NPI
Nicole Marie Kinnard, BCBA
- Behavior Analyst
- Pensacola, FL
National Provider Identifier
1104141530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-12-11689
- Practice address
- 4130 Kingsberry Dr
Pensacola, FL 32504-8436 - Phone
- (850) 380-5681
- NPI assigned
- Mar 29, 2010
- Sex
- Female
- 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 | 1-12-11689 | FL | Primary |
Addresses
Primary practice location
4130 Kingsberry Dr
Pensacola, FL 32504-8436
Mailing address
4130 Kingsberry Dr
Pensacola, FL 32504-8436
Phone (850) 380-5681
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343260800000",
"number": "1104141530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4130 KINGSBERRY DR",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325048436",
"telephone_number": "850-380-5681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4130 KINGSBERRY DR",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325048436",
"telephone_number": "850-380-5681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINNARD",
"first_name": "NICOLE",
"middle_name": "MARIE",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-29",
"last_updated": "2012-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "FL",
"license": "1-12-11689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.