Individual provider Active NPI

Megan Ifebuzo, BCBA

  • Behavior Analyst
  • Huntersville, NC
National Provider Identifier
1275112518
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-23-63974 Issued in NC
Practice address
16415 Northcross Dr Ste F
Huntersville, NC 28078-5001
Phone
(704) 799-6824
Fax
(704) 799-6825
NPI assigned
Apr 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-23-63974 NC Primary

Addresses

Primary practice location

16415 Northcross Dr Ste F
Huntersville, NC 28078-5001

Mailing address

134 Infield CT
Mooresville, NC 28117-8026
Phone (704) 799-6824

Other practice location 1

134 Infield Ct
Mooresville, NC 28117-8026
Phone (704) 799-6824

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

OrganizationSpecialtyStatusNew patients
Integrative Therapy Concepts PastSince Aug 13, 2023 Accepting new patients
Lolly Therapeutics, LLC Behavior Analyst PastSince Aug 13, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1275112518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 INFIELD CT",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178026",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16415 NORTHCROSS DR STE F",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785001",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 Infield Ct",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281178026",
            "country_code": "US",
            "telephone_number": "704-799-6824",
            "fax_number": "704-799-6825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IFEBUZO",
        "first_name": "MEGAN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "1-23-63974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.