Individual provider Active NPI

Katelyn Nicole Gilmore, MA

  • Behavior Technician
  • Indianapolis, IN
National Provider Identifier
1215510151
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-22-205955 Issued in IN
Practice address
8063 Madison Ave
Indianapolis, IN 46227-6001
Phone
(845) 826-3721
NPI assigned
Apr 29, 2021
Last updated
Feb 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Behavior Technician 106S00000X RBT-22-205955 IN Primary

Addresses

Primary practice location

8063 Madison Ave
Indianapolis, IN 46227-6001

Mailing address

8063 Madison Ave
Indianapolis, IN 46227-6001
Phone (845) 826-3721

Other practice location 1

4201 Varsity Dr Ste C
Ann Arbor, MI 48108-5005
Phone (734) 926-0740

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 Arts

State licenses

LicenseStateTypeSpecialty
RBT-22-205955INMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Creating Brighter Futures CurrentSince May 1, 2021 Accepting new patients
Creating Brighter Futures, Inc CurrentSince May 1, 2021 Accepting new patients

Locations

4201 Varsity Dr
Ste C
Ann Arbor, MI 48108
Phone (734) 926-0740

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1215510151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8063 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276001",
            "telephone_number": "845-826-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8063 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276001",
            "telephone_number": "845-826-3721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Varsity Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481085005",
            "country_code": "US",
            "telephone_number": "734-926-0740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "KATELYN",
        "middle_name": "NICOLE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-22-205955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.