Active NPI
Kellie Reynolds
- Behavior Analyst
- Dallas, TX
National Provider Identifier
1356785935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 008601
- Practice address
- 9900 N Central Expy
Suite 300
Dallas, TX 75231-4395 - Phone
- (214) 265-0420
- Fax
- (817) 789-6849
- NPI assigned
- Apr 25, 2013
- 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 | 008601 | TX | Primary |
Addresses
Primary practice location
9900 N Central Expy
Suite 300
Dallas, TX 75231-4395
Mailing address
305 NE Loop 820
Business Tower 1; Suite 200
Hurst, TX 76053-7209
Phone (817) 292-8787
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 149984001 | Medicaid | TX | |
| 207164901 | Medicaid | TX |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Epic Pediatric Therapy, LP | Behavior Analyst | Past | Accepting new patients |
| Epic Pediatric Therapy, LP. | Past | 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.
-
- Rehabilitation Clinic/Center
- Arlington, TX
- NPI 1013163377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366848000000",
"number": "1356785935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 NE LOOP 820",
"address_2": "BUSINESS TOWER 1; SUITE 200",
"city": "HURST",
"state": "TX",
"postal_code": "760537209",
"telephone_number": "817-292-8787",
"fax_number": "817-789-6849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 N CENTRAL EXPY",
"address_2": "SUITE 300",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314395",
"telephone_number": "214-265-0420",
"fax_number": "817-789-6849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "KELLIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-25",
"last_updated": "2013-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "008601",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "149984001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207164901",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.