Individual provider Active NPI

Lydia Kimble, RBT

  • Behavior Technician
  • Greenwood, IN
National Provider Identifier
1104717016
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-446263 Issued in IN
Practice address
1217 Old Vines TRL
Greenwood, IN 46143-3412
Phone
(317) 533-3507
NPI assigned
Jul 10, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-25-446263 IN Primary

Addresses

Primary practice location

1217 Old Vines TRL
Greenwood, IN 46143-3412

Mailing address

1217 Old Vines TRL
Greenwood, IN 46143-3412

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

State licenses

LicenseStateTypeSpecialty
RBT-25-446263INMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Medequip Solutions LLC CurrentSince Jul 13, 2025 Accepting new patients
Achieve Behavior Alliance Plus, LLC Behavior Technician CurrentSince Jul 13, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1104717016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 OLD VINES TRL",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461433412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 OLD VINES TRL",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461433412",
            "telephone_number": "317-533-3507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBLE",
        "first_name": "LYDIA",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-25-446263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.