Individual provider Active NPI

Seth Johnston, MS

  • Behavior Analyst
  • Bentonville, AR
National Provider Identifier
1144799636
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-21-48450 Issued in AR
Practice address
2703 SE Otis Corley Dr
Bentonville, AR 72712-3864
Phone
(917) 905-0139
NPI assigned
Nov 14, 2018
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X NU
Behavior Analyst 103K00000X 1-21-48450 AR Primary

Addresses

Primary practice location

2703 SE Otis Corley Dr
Bentonville, AR 72712-3864

Mailing address

2703 SE Otis Corley Dr
Bentonville, AR 72712-3864
Phone (917) 905-0139

Other practice location 1

1500 Cheri Whitlock Dr
Siloam Springs, AR 72761-9100
Phone (479) 967-2322 ext. 227

Other identifiers 1

IdentifierTypeStateIssuer
203528721MedicaidAR

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
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1144799636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 SE OTIS CORLEY DR",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123864",
            "telephone_number": "917-905-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 SE OTIS CORLEY DR",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123864",
            "telephone_number": "917-905-0139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Cheri Whitlock Dr",
            "address_purpose": "LOCATION",
            "city": "Siloam Springs",
            "state": "AR",
            "postal_code": "727619100",
            "country_code": "US",
            "telephone_number": "479-967-2322 x227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "SETH",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-14",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AR",
            "license": "1-21-48450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203528721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.