Robyn Kelly, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-14-15064 Issued in SC

Practice address

113 Saluda Shores Cir
Leesville, SC 29070-7235

Phone

(803) 920-7871

Fax

(803) 234-2927

NPI assigned

Apr 20, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Atlas Supports

  • Behavior Analyst
  • Leesville, SC
  • NPI 1275868556
  NPD (past)

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1376930198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 SALUDA SHORES CIR",
            "city": "LEESVILLE",
            "state": "SC",
            "postal_code": "290707235",
            "telephone_number": "803-920-7871",
            "fax_number": "803-234-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 SALUDA SHORES CIR",
            "city": "LEESVILLE",
            "state": "SC",
            "postal_code": "290707235",
            "telephone_number": "803-920-7871",
            "fax_number": "803-234-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "ROBYN",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "SC",
            "license": "1-14-15064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Leesville, SC
• Providers in Leesville, SC by specialty
• Behavior Analyst in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.