Active NPI
Kelly Mize Autry, M.S., BCBA, LBA
- Behavior Analyst
- Birmingham, AL
National Provider Identifier
1205196557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-10-7788
- Practice address
- 150 Glenwood LN
Birmingham, AL 35242-5700 - Phone
- (205) 795-3242
- NPI assigned
- May 21, 2012
- Last updated
- Aug 19, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-10-7788 | NU | Primary |
Addresses
Primary practice location
150 Glenwood LN
Birmingham, AL 35242-5700
Mailing address
150 Glenwood LN
Birmingham, AL 35242-5700
Phone (205) 795-3242
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": "1337558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629331200000",
"number": "1205196557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 GLENWOOD LN",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352425700",
"telephone_number": "205-795-3242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 GLENWOOD LN",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352425700",
"telephone_number": "205-795-3242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUTRY",
"first_name": "KELLY",
"middle_name": "MIZE",
"name_prefix": "Ms.",
"credential": "M.S., BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-21",
"last_updated": "2021-08-19",
"certification_date": "2021-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": "1-10-7788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.