Kylie Rae Dombrosky, MED, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

271493 Issued in KY

Practice address

3761 Johnson Hall Dr
Masonic Home, KY 40041-9998

Phone

(502) 633-1007

Fax

(502) 805-1511

NPI assigned

Sep 30, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kylie Rae Dombrosky Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1215544481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HOWARD DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658138",
            "telephone_number": "502-633-1007",
            "fax_number": "502-805-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3761 JOHNSON HALL DR",
            "city": "MASONIC HOME",
            "state": "KY",
            "postal_code": "400419998",
            "telephone_number": "502-633-1007",
            "fax_number": "502-805-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMBROSKY",
        "first_name": "KYLIE",
        "middle_name": "RAE",
        "credential": "MED, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "KY",
            "license": "RBT-19-99776",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "271493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-21-50514",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "DOMBROSKY",
            "middle_name": "RAE",
            "credential": "BS, RBT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shannon Carty-Janis, MS, BCBA, LBA
• Morgan Kaye Chambliss
• Austin Hope Clark
• Jolie Dandurand
• Mackenzie Dial, RBT
• Fresenius Medical Care Masonic Homes, LLC
• Ivonne Gonzalez Hermosillo
• Shannon Marie Gostel
• Connor Brooks Hagan, BS, RBT
• Madison Jo Hammond

• All providers in Masonic Home, KY
• Behavior Analyst in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.