Active NPI
Mary Elisabeth Smith, BA
- Behavior Analyst
- Brookfield, WI
National Provider Identifier
1114337995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 83-140
- Practice address
- 150 N Sunny Slope Rd
Suite #100
Brookfield, WI 53005-4806 - Phone
- (262) 432-5660
- Fax
- (262) 432-5666
- NPI assigned
- May 2, 2014
- Sex
- Female
- 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 Analyst | 103K00000X | 83-140 | WI | Primary |
Addresses
Primary practice location
150 N Sunny Slope Rd
Suite #100
Brookfield, WI 53005-4806
Mailing address
150 N Sunny Slope Rd
Suite #100
Brookfield, WI 53005-4806
Phone (262) 432-5660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 83-140 | Other | WI | BA LICENSE |
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83-140 | WI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398988800000",
"number": "1114337995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 N SUNNY SLOPE RD",
"address_2": "SUITE #100",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530054806",
"telephone_number": "262-432-5660",
"fax_number": "262-432-5666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 N SUNNY SLOPE RD",
"address_2": "SUITE #100",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530054806",
"telephone_number": "262-432-5660",
"fax_number": "262-432-5666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "MARY",
"middle_name": "ELISABETH",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-02",
"last_updated": "2014-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "WI",
"license": "83-140",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BA LICENSE",
"identifier": "83-140",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.