Active NPI
Kelsi Moore
- Behavior Technician
- Bloomington, IN
National Provider Identifier
1225507353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 451 S Park Ridge Rd
Bloomington, IN 47401-8589 - Phone
- (317) 334-7331
- NPI assigned
- Nov 19, 2018
- 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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
451 S Park Ridge Rd
Bloomington, IN 47401-8589
Mailing address
451 S Park Ridge Rd
Bloomington, IN 47401-8589
Phone (317) 334-7331
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K1DS Count Therapy, LLC | Behavior Technician | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600560000000",
"number": "1225507353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 S PARK RIDGE RD",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474018589",
"telephone_number": "317-334-7331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 S PARK RIDGE RD",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474018589",
"telephone_number": "317-334-7331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KELSI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-19",
"last_updated": "2020-09-20",
"certification_date": "2020-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.