Active NPI
Krista Willis
- Behavior Analyst
- Virginia Beach, VA
National Provider Identifier
1154979979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-23-67329
- Practice address
- 5606B Virginia Beach Blvd Ste 103
Virginia Beach, VA 23462-5680 - Phone
- (804) 750-0539
- NPI assigned
- Aug 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-23-67329 | DE | Primary |
| Behavior Technician | 106S00000X | RBT-15-05694 | DE |
Addresses
Primary practice location
5606B Virginia Beach Blvd Ste 103
Virginia Beach, VA 23462-5680
Mailing address
5606B Virginia Beach Blvd Ste 103
Virginia Beach, VA 23462-5680
Phone (804) 750-0539
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-15-05694 | DE | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1154979979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5606B VIRGINIA BEACH BLVD STE 103",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234625680",
"telephone_number": "804-750-0539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5606B VIRGINIA BEACH BLVD STE 103",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234625680",
"telephone_number": "804-750-0539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "KRISTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-27",
"last_updated": "2024-07-10",
"certification_date": "2024-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "DE",
"license": "1-23-67329",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "DE",
"license": "RBT-15-05694",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.