Individual provider Active NPI

Adelaide Ball, MA, BCBA, LBA-OR/TX

  • Behavior Analyst
  • Gresham, OR
National Provider Identifier
1255843371
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
912 NE Kelly Ave
Gresham, OR 97030-5629
Phone
(855) 772-8847
NPI assigned
Oct 30, 2017
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary
Behavior Technician 106S00000X RBT-17-43008 NC

Addresses

Primary practice location

912 NE Kelly Ave
Gresham, OR 97030-5629

Mailing address

1635 SE Spokane St
Portland, OR 97202-6708
Phone (971) 373-4028

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

State licenses

LicenseStateTypeSpecialty
RBT-17-43008NCMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Autism Society of North Carolina, Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1255843371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 SE SPOKANE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972026708",
            "telephone_number": "971-373-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 NE KELLY AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305629",
            "telephone_number": "855-772-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALL",
        "first_name": "ADELAIDE",
        "credential": "MA, BCBA, LBA-OR/TX",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NC",
            "license": "RBT-17-43008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.