Individual provider Active NPI

Kaitlyn Joines, BCBA

  • Behavior Analyst
  • Beaumont, TX
National Provider Identifier
1114400751
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
5647 Issued in TX
Practice address
855 S 8TH St
Beaumont, TX 77701-4603
Phone
(409) 838-6568
Fax
(098) 381-3374
NPI assigned
Sep 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 5647 TX Primary
Behavior Technician 106S00000X TX
Other Technician 247200000X

Addresses

Primary practice location

855 S 8TH St
Beaumont, TX 77701-4603

Mailing address

855 S 8TH St
Beaumont, TX 77701-4603
Phone (409) 838-6568

Other names 1

  • Kaitlyn Ebner Former name

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
5647TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Richard L Shorkey Education & Rehabilitation Center Behavior Analyst PastSince Feb 26, 2023 Accepting new patients

Organizations & group practices 1

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": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1114400751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S 8TH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014603",
            "telephone_number": "409-838-6568",
            "fax_number": "098-381-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 S 8TH ST",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014603",
            "telephone_number": "409-838-6568",
            "fax_number": "098-381-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOINES",
        "first_name": "KAITLYN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "5647",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "EBNER",
            "credential": "BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.