Kaitlyn Gordon, BCABA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0-22-13843 Issued in AR

Practice address

1301 Museum Rd
Conway, AR 72032-4739

Phone

(501) 358-6535

NPI assigned

Sep 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Reach Therapy Services LLC

  • Physical Therapist
  • Conway, AR
  • NPI 1649748682
  NPD

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1255980199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MUSEUM RD",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324739",
            "telephone_number": "501-358-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MUSEUM RD",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324739",
            "telephone_number": "501-358-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KAITLYN",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "AR",
            "license": "0-22-13843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255980199",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Aaron Goodman
• Shreya Gopal
• Muhammad Arqam Iqbal Goraya, MD
• Deborah Gordon, LPN
• Jamie Lee Gordon, LPC-S
• Spencer Preston Gordy, DDS
• Glenda Darlene Gore, FNP-BC
• Quincy Goree, RECOVERY ASSISTANT
• Laura Gottsponer
• Kayla Gowin, LAC

• Assistant Behavior Analyst in Conway, AR
• Providers in Conway, AR by specialty
• Assistant Behavior Analyst in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.

Verify at the official NPI Registry.