Gregory Richmond Mancil, BCBA-D, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

KY-0017 Issued in KY

Practice address

730 Fairview Avenue Suite B-5
Bowling Green, KY 42101

Phone

(270) 904-5071

Fax

(270) 904-5072

NPI assigned

Sep 3, 2011

Last updated

Jul 16, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holy Angels Residential Facility

  dba Holy Angels Autism Center

  • Behavior Analyst
  • Shreveport, LA
  • NPI 1578014387
  NPD (past)

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

{
    "created_epoch": "1315008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1255612289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 WAKEFIELD ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421031551",
            "telephone_number": "502-298-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 FAIRVIEW AVENUE SUITE B-5",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42101",
            "telephone_number": "270-904-5071",
            "fax_number": "270-904-5072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCIL",
        "first_name": "GREGORY",
        "middle_name": "RICHMOND",
        "name_prefix": "Dr.",
        "credential": "BCBA-D, LBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-03",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "KY-0017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chaitanya Sree Malempati, D.O.
• Gregg A Malmquist, M.D.
• Amber Malone
• Jenna Mamatov, DO
• Krista Manche, DMD
• Anthony Robert Mancini, PT
• Sara L. Mangold, M.D.
• Gatwech Chuol Manguet
• Christina Annette Mann, C,N,M.
• Malorie M. Mann, APRN, FNP-C

• Behavior Analyst in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Behavior Analyst in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.