Active NPI
Micheal Thomas Arnold, RBT
- Behavior Technician
- Bridgeport, MI
National Provider Identifier
1225612609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 6296 Bridgeport Village Square Dr
Bridgeport, MI 48722-9655 - Phone
- (989) 401-1239
- NPI assigned
- May 11, 2021
- Last updated
- Dec 9, 2022
- Sex
- Male
- Sole proprietor
- Yes
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
6296 Bridgeport Village Square Dr
Bridgeport, MI 48722-9655
Mailing address
5039 Villa Linde Parkway
Suite #30
Flint, MI 48532
Phone (989) 401-2244
Other practice location 1
3258 Ringle Rd
Akron, MI 48701-9519
Phone (989) 551-0112
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225612609 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | micheal@autismsystemsaba.com | Health Information Exchange (HIE) | Autism Systems LLC |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670544000000",
"number": "1225612609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5039 VILLA LINDE PARKWAY",
"address_2": "SUITE #30",
"city": "FLINT",
"state": "MI",
"postal_code": "48532",
"telephone_number": "989-401-2244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6296 BRIDGEPORT VILLAGE SQUARE DR",
"city": "BRIDGEPORT",
"state": "MI",
"postal_code": "487229655",
"telephone_number": "989-401-1239"
}
],
"practiceLocations": [
{
"address_1": "3258 Ringle Rd",
"address_purpose": "LOCATION",
"city": "Akron",
"state": "MI",
"postal_code": "487019519",
"country_code": "US",
"telephone_number": "989-551-0112",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ARNOLD",
"first_name": "MICHEAL",
"middle_name": "THOMAS",
"credential": "RBT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-11",
"last_updated": "2022-12-09",
"certification_date": "2022-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1225612609",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "micheal@autismsystemsaba.com",
"affiliation": "Y",
"endpointDescription": "Company Email",
"affiliationName": "Autism Systems LLC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "ABA",
"address_1": "6296 Bridgeport Village Square Dr",
"city": "Bridgeport",
"state": "MI",
"country_code": "US",
"postal_code": "487229655",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bridgeport, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.