Active NPI
Parker Ryan Light
- Behavior Technician
- Saint Louis, MO
National Provider Identifier
1104449156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 518 Selma Ave
Saint Louis, MO 63119-4142 - Phone
- (314) 910-8371
- NPI assigned
- May 26, 2020
- Sex
- Male
- Sole proprietor
- No
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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
518 Selma Ave
Saint Louis, MO 63119-4142
Mailing address
518 Selma Ave
Saint Louis, MO 63119-4142
Other practice location 1
12747 Olive Blvd Ste 300
Saint Louis, MO 63141-6269
Phone (833) 490-8535
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": "1590451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590451200000",
"number": "1104449156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "518 SELMA AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631194142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "518 SELMA AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631194142",
"telephone_number": "314-910-8371"
}
],
"practiceLocations": [
{
"address_1": "12747 Olive Blvd Ste 300",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631416269",
"country_code": "US",
"telephone_number": "833-490-8535",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LIGHT",
"first_name": "PARKER",
"middle_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-26",
"last_updated": "2020-05-26",
"certification_date": "2020-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.