Active NPI
Autumn Andrus
- Behavior Analyst
- Kentwood, MI
National Provider Identifier
1245789429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 2622 Briarwood CT SE
Kentwood, MI 49512-9084 - Phone
- (517) 285-5260
- NPI assigned
- Sep 28, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary | ||
| Other Technician | 247200000X |
Addresses
Primary practice location
2622 Briarwood CT SE
Kentwood, MI 49512-9084
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Other practice location 1
2400 Science Pkwy
Okemos, MI 48864-2560
Phone (517) 927-8696
Other practice location 2
2501 Daisy Ln
Middleville, MI 49333-8140
Phone (616) 325-0830
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 |
|---|---|---|---|
| Residential Options, Inc. | Behavior Analyst | 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.
-
- Behavior Analyst
- Lansing, MI
- NPI 1336475532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669766400000",
"number": "1245789429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2622 BRIARWOOD CT SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495129084",
"telephone_number": "517-285-5260"
}
],
"practiceLocations": [
{
"address_1": "2400 Science Pkwy",
"address_purpose": "LOCATION",
"city": "Okemos",
"state": "MI",
"postal_code": "488642560",
"country_code": "US",
"telephone_number": "517-927-8696",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2501 Daisy Ln",
"address_purpose": "LOCATION",
"city": "Middleville",
"state": "MI",
"postal_code": "493338140",
"country_code": "US",
"telephone_number": "616-325-0830",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDRUS",
"first_name": "AUTUMN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-28",
"last_updated": "2022-11-30",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kentwood, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.