Amanda B Phillips, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1118292 Issued in IN

Practice address

1314 N Liberty Cir W
Greensburg, IN 47240-6647

Phone

(812) 663-2273

Fax

(812) 663-2275

NPI assigned

Dec 22, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Blue ABA Indiana LLC

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1346972882

  Behavior Analyst

  NPD (past)
• Disability and Autism Services of Indiana LLC

  • Behavior Analyst
  • Saint Paul, IN
  • NPI 1710202171
  NPD (past)

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1124397997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 TOUBY PIKE STE B",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469012573",
            "telephone_number": "765-628-7400",
            "fax_number": "765-450-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 N LIBERTY CIR W",
            "city": "GREENSBURG",
            "state": "IN",
            "postal_code": "472406647",
            "telephone_number": "812-663-2273",
            "fax_number": "812-663-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "AMANDA",
        "middle_name": "B",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-22",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1118292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300010163",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johanna Dawn Painter, CCC-SLP
• Evelyn T Panzer, ARNP
• Kiara Parker, RBT
• Ciara Paugh
• Timothy Michael Peklo, MD
• Karen Brian Pollitt, CPNP
• Leann Beth Porter
• Practicing Physicians of Greensburg
• Holly M Pray, REGISTERED DIETICIAN
• Beth Ann Preston, RPH

• All providers in Greensburg, IN
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.