Kelly Parker, MA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-29633 Issued in IN

Practice address

4655 Rosebud LN
Newburgh, IN 47630

Phone

(812) 213-8031

Fax

(765) 454-9759

NPI assigned

Apr 5, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Kelly Yang Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Harsha Autism Center, LCC

  • Behavior Analyst
  • Terre Haute, IN
  • NPI 1952731788
  NPD (past)
• Hopebridge, LLC

  • Child & Adolescent Psychiatry Physician
  • Kokomo, IN
  • NPI 1891820668

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1366948564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BOULEVARD",
            "address_2": "SUITE 3070",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "765-454-9759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 ROSEBUD LN",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "47630",
            "telephone_number": "812-213-8031",
            "fax_number": "765-454-9759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 W Johnson Dr",
            "address_purpose": "LOCATION",
            "city": "Terre Haute",
            "state": "IN",
            "postal_code": "478025508",
            "country_code": "US",
            "telephone_number": "812-233-8833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "KELLY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-18-29633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA LICENSE",
            "identifier": "1-18-29663",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA",
            "identifier": "1-18-29663",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "YANG",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Emily Owen
• Allison Paddock
• Katherine Michelle Paddock
• Frank X Pamelia, M.D.
• Christine Virginia Pankau, NP
• Emily Parmenter
• Kelsey Annette Partenheimer, OTR
• Pooja Roopesh Patel, MD
• Adriana Rose Patterson
• Erin Renee Patton, OTR

• Behavior Analyst in Newburgh, IN
• Providers in Newburgh, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.