Individual provider Active NPI

Adrienne Ellers, BCBA

  • Behavior Analyst
  • Dunnellon, FL
National Provider Identifier
1124546098
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-08-4602 Issued in FL
Practice address
11808 N Ohio St
Dunnellon, FL 34431-6724
Phone
(352) 342-5006
NPI assigned
Aug 31, 2017
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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 1-08-4602 FL Primary

Addresses

Primary practice location

11808 N Ohio St
Dunnellon, FL 34431-6724

Mailing address

4981 N Baywood Dr
Beverly Hills, FL 34465-4504
Phone (352) 342-5006

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practical Behavior Solutions, LLC Behavior Analyst CurrentSince May 1, 2021 Accepting new patients
Omega Behavior Analysis LLC Past Accepting new patients
Omega Behavior Analysis, LLC Past Accepting new patients

Locations

11808 N Ohio St
Dunnellon, FL 34431
Phone (352) 342-5006

20785 W McKinney Ave
Dunnellon, FL 34431
Phone (352) 342-5006

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1124546098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4981 N BAYWOOD DR",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344654504",
            "telephone_number": "352-342-5006",
            "fax_number": "352-245-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11808 N OHIO ST",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "344316724",
            "telephone_number": "352-342-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERS",
        "first_name": "ADRIENNE",
        "name_prefix": "Dr.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-08-4602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunnellon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.