The Redwood Academy

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

THE REDWOOD ACADEMY

Practice address

2401 Hawthorn PL
Noblesville, IN 46062-8514

Phone

(317) 450-0242

NPI assigned

Aug 30, 2022

Organization subpart

No

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

Authorized official

Name

Kelly Davisson

Title

President & Co-Founder

Phone

(317) 207-0645

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1346960432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 HAWTHORN PL",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460628514",
            "telephone_number": "317-450-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 HAWTHORN PL",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460628514",
            "telephone_number": "317-450-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE REDWOOD ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-10-31",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "DAVISSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT & CO-FOUNDER",
        "authorized_official_telephone_number": "317-207-0645"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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