Active NPI
Kelly Robben, BCBA
- Behavior Analyst
- Boise, ID
National Provider Identifier
1356861819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-17-27016
- Practice address
- 9917 W Antietam St
Boise, ID 83709-3405 - Phone
- (850) 797-8280
- NPI assigned
- Jun 26, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | 0177958 | FL | |
| Behavior Analyst | 103K00000X | 1-17-27016 | Primary |
Addresses
Primary practice location
9917 W Antietam St
Boise, ID 83709-3405
Mailing address
80 College Blvd E
Niceville, FL 32578-1343
Phone (850) 279-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1-17-27016 | Other | BACB |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0177958 | FL | MD | Assistant Behavior Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K-Now Behavioral Solutions, LLC | Behavior Analyst | Past | Accepting new patients |
| Inclusion ABA LLC | Behavior Analyst | Past | Accepting new patients |
| Emerald Coast Autism Center | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Community/Behavioral Health Agency
- Niceville, FL
- NPI 1972030617
-
- Behavior Analyst
- Livingston, TX
- NPI 1962163857
-
- Behavior Analyst
- Hill City, SD
- NPI 1679174411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678060800000",
"number": "1356861819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 COLLEGE BLVD E",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325781343",
"telephone_number": "850-279-3000",
"fax_number": "850-389-2269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9917 W ANTIETAM ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837093405",
"telephone_number": "850-797-8280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBBEN",
"first_name": "KELLY",
"name_prefix": "Mrs.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-26",
"last_updated": "2023-03-06",
"certification_date": "2023-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "FL",
"license": "0177958",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-17-27016",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB",
"identifier": "1-17-27016",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.