Individual provider Active NPI

Andrea S Van Horn

  • Behavior Analyst
  • Cape Girardeau, MO
National Provider Identifier
1174848345
Registry record updated Oct 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2018036493 Issued in MO
Practice address
338 Broadway St Ste 301
Cape Girardeau, MO 63701-7331
Phone
(573) 225-6678
NPI assigned
Mar 31, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2018

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 2018036493 MO Primary

Addresses

Primary practice location

338 Broadway St Ste 301
Cape Girardeau, MO 63701-7331

Mailing address

338 Broadway St Ste 301
Cape Girardeau, MO 63701-7331
Phone (573) 225-6678

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
2018036493MOMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1174848345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 BROADWAY ST STE 301",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637017331",
            "telephone_number": "573-225-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 BROADWAY ST STE 301",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637017331",
            "telephone_number": "573-225-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HORN",
        "first_name": "ANDREA",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2018036493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.