Individual provider Active NPI

Kelli Allen

  • Behavior Analyst
  • Orlando, FL
National Provider Identifier
1366099640
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2154 Central Florida Pkwy Ste B2
Orlando, FL 32837-8986
Phone
(636) 368-1117
NPI assigned
Aug 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

2154 Central Florida Pkwy Ste B2
Orlando, FL 32837-8986

Mailing address

6650 Bay Shore Dr
Saint Cloud, FL 34771-9570
Phone (623) 628-5037

Other practice location 1

6650 Bay Shore Dr
Saint Cloud, FL 34771-9570
Phone (623) 628-5037

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

OrganizationSpecialtyStatusNew patients
Prevail Academy School and Behavior Services Behavior Analyst CurrentSince Jan 17, 2022 Accepting new patients
Amazing Gains Behavior Therapy Services LLC PastSince Dec 1, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1366099640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 BAY SHORE DR",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347719570",
            "telephone_number": "623-628-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154 CENTRAL FLORIDA PKWY STE B2",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378986",
            "telephone_number": "636-368-1117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6650 Bay Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "FL",
            "postal_code": "347719570",
            "country_code": "US",
            "telephone_number": "623-628-5037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.

Verify at the official NPI Registry.