Active NPI
Kelly Davis, BCBA
- Behavior Analyst
- Forrest City, AR
National Provider Identifier
1336718758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-21-47446
- Practice address
- 3998 Highway 1 N
Forrest City, AR 72335-7637 - Phone
- (870) 633-7137
- Fax
- (870) 551-3724
- NPI assigned
- Jun 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-21-47446 | AR | Primary |
Addresses
Primary practice location
3998 Highway 1 N
Forrest City, AR 72335-7637
Mailing address
PO Box 2192
Forrest City, AR 72336-2192
Phone (870) 208-8362
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1336718758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2192",
"city": "FORREST CITY",
"state": "AR",
"postal_code": "723362192",
"telephone_number": "870-208-8362",
"fax_number": "870-208-8384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3998 HIGHWAY 1 N",
"city": "FORREST CITY",
"state": "AR",
"postal_code": "723357637",
"telephone_number": "870-633-7137",
"fax_number": "870-551-3724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KELLY",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-21",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AR",
"license": "1-21-47446",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forrest City, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.