Individual provider Active NPI

Sarah Kimbro, MA

  • Behavior Analyst
  • Canton, GA
National Provider Identifier
1215661491
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-22-60438 Issued in GA
Practice address
760 Bridgeview Dr
Canton, GA 30115-2330
Phone
(404) 281-2253
NPI assigned
Jul 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-22-60438 GA Primary

Addresses

Primary practice location

760 Bridgeview Dr
Canton, GA 30115-2330

Mailing address

760 Bridgeview Dr
Canton, GA 30115-2330
Phone (404) 281-2253

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

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1215661491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BRIDGEVIEW DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301152330",
            "telephone_number": "404-281-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 BRIDGEVIEW DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301152330",
            "telephone_number": "404-281-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBRO",
        "first_name": "SARAH",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-22-60438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

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