NPIMap

Organization Active NPI

Bluegrass Center for Autism

  • Behavior Technician
  • Louisville, KY
National Provider Identifier
1184423808
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Legal business name
BLUEGRASS CENTER FOR AUTISM
Practice address
9300 Cedar Center Way Ste 200
Louisville, KY 40291-4522
Phone
(502) 473-7219
Fax
(502) 709-9892
NPI assigned
Mar 13, 2025
Organization subpart
Yes
Parent organization
BLUEGRASS CENTER FOR AUTISMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Authorized official

Name
Jennifer L Wilt
Title
Director
Phone
(502) 443-3836

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X Primary

Addresses

Primary practice location

9300 Cedar Center Way Ste 200
Louisville, KY 40291-4522

Mailing address

9300 Cedar Center Way Ste 200
Louisville, KY 40291-4522
Phone (502) 473-7219

Other practice location 1

1405 E Burnett Ave
Louisville, KY 40217-1577
Phone (502) 473-7219

Other identifiers 1

IdentifierTypeStateIssuer
7100700160MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Bluegrass Center for Autism3 organizations share this tax ID, including this one
Part of
Bluegrass Center for Autism

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9300 Cedar Center Way
Ste 200
Louisville, KY 40291
Phone (502) 473-7219

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1184423808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 CEDAR CENTER WAY STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402914522",
            "telephone_number": "502-473-7219",
            "fax_number": "502-709-9892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 CEDAR CENTER WAY STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402914522",
            "telephone_number": "502-473-7219",
            "fax_number": "502-709-9892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 E Burnett Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402171577",
            "country_code": "US",
            "telephone_number": "502-473-7219",
            "fax_number": "502-709-9892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUEGRASS CENTER FOR AUTISM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUEGRASS CENTER FOR AUTISM",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A",
        "authorized_official_last_name": "WILT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "502-443-3836"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100700160",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.