NPIMap

Organization Active NPI

Lee University

  • Behavior Analyst
  • Cleveland, TN
National Provider Identifier
1194100727
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-08-4396 Issued in TN
Legal business name
LEE UNIVERSITY
Practice address
1120 N Ocoee St
Cleveland, TN 37311-4458
Phone
(423) 614-8000
Fax
(423) 614-9180
NPI assigned
Jul 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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

Authorized official

Name
Dr. Tamara Johnson, ED.D., BCBA-D
Title
Ludic Director
Phone
(423) 961-3785

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 1-08-4396 TN Primary

Addresses

Primary practice location

1120 N Ocoee St
Cleveland, TN 37311-4458

Mailing address

1120 N Ocoee St
Cleveland, TN 37311-4458
Phone (423) 614-8190

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidTN

Other names 1

  • Lee University Developmental Inclusion Classrooms (LUDIC) Doing business as

National Provider Directory

National Provider Directory

Locations

1120 N Ocoee St
Cleveland, TN 37311
Phone (423) 614-8000

Practitioners & affiliated clinicians

Practitioners 6

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": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437696000000",
    "number": "1194100727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N OCOEE ST",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373114458",
            "telephone_number": "423-614-8190",
            "fax_number": "423-614-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N OCOEE ST",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373114458",
            "telephone_number": "423-614-8000",
            "fax_number": "423-614-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2015-07-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "LUDIC DIRECTOR",
        "authorized_official_telephone_number": "423-961-3785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D., BCBA-D"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "1-08-4396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lee University Developmental Inclusion Classrooms (LUDIC)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.