Individual provider Active NPI

McKenzie Gunter

  • Behavior Analyst
  • Kirksville, MO
National Provider Identifier
1114519147
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2021003129 Issued in MO
Practice address
1101 Jamison St
Kirksville, MO 63501-3943
Phone
(660) 665-1962
Fax
(660) 627-0642
NPI assigned
Feb 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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 2021003129 MO Primary

Addresses

Primary practice location

1101 Jamison St
Kirksville, MO 63501-3943

Mailing address

1601 Old South River Rd
Saint Charles, MO 63303-4120
Phone (636) 224-1210

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
2021003129MOMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1114519147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OLD SOUTH RIVER RD",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633034120",
            "telephone_number": "636-224-1210",
            "fax_number": "636-246-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 JAMISON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013943",
            "telephone_number": "660-665-1962",
            "fax_number": "660-627-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNTER",
        "first_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2021003129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.