Individual provider Active NPI

Amanda N Evanson, RBT

  • Behavior Analyst
  • Colorado Springs, CO
National Provider Identifier
1285116756
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
18-64191 Issued in CO
Practice address
2706 Fieldstone Road
Colorado Springs, CO 80919
Phone
(719) 203-6903
NPI assigned
Aug 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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 18-64191 CO Primary

Addresses

Primary practice location

2706 Fieldstone Road
Colorado Springs, CO 80919

Mailing address

2760 Fieldstone Rd
Colorado Springs, CO 80919-3100
Phone (719) 203-6903

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

State licenses

LicenseStateTypeSpecialty
18-64191COMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1285116756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 FIELDSTONE RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809193100",
            "telephone_number": "719-203-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 FIELDSTONE ROAD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80919",
            "telephone_number": "719-203-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANSON",
        "first_name": "AMANDA",
        "middle_name": "N",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "18-64191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.