Individual provider Active NPI

Ashley Bragg, BCBA, LBA

  • Behavior Analyst
  • Russell Springs, KY
National Provider Identifier
1104644152
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2465 Lakeway Dr
Russell Springs, KY 42642-4510
Phone
(606) 677-1166
NPI assigned
Sep 30, 2024
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X KY Primary

Addresses

Primary practice location

2465 Lakeway Dr
Russell Springs, KY 42642-4510

Mailing address

215 Weed Keltner Rd
Edmonton, KY 42129-8814
Phone (270) 634-4377

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": "1727654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1104644152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 WEED KELTNER RD",
            "city": "EDMONTON",
            "state": "KY",
            "postal_code": "421298814",
            "telephone_number": "270-634-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 LAKEWAY DR",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426424510",
            "telephone_number": "606-677-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAGG",
        "first_name": "ASHLEY",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Russell Springs, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.