Individual provider Active NPI

Emily Bailey, RBT

  • Behavior Analyst
  • Fayetteville, AR
National Provider Identifier
1376994756
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
12044989 Issued in AR
Practice address
2474 E Joyce Blvd Ste 2
Fayetteville, AR 72703-4932
Phone
(479) 841-4938
Fax
(479) 521-5439
NPI assigned
Jun 27, 2016
Last updated
Nov 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X AR
Behavior Analyst 103K00000X 12044989 AR Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

2474 E Joyce Blvd Ste 2
Fayetteville, AR 72703-4932

Mailing address

2474 E Joyce Blvd Ste 2
Fayetteville, AR 72703-4932
Phone (479) 841-4938

Other names 1

  • Emily Anderson Former name

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

LicenseStateTypeSpecialty
12044989ARMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1376994756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2474 E JOYCE BLVD STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034932",
            "telephone_number": "479-841-4938",
            "fax_number": "479-521-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2474 E JOYCE BLVD STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034932",
            "telephone_number": "479-841-4938",
            "fax_number": "479-521-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "EMILY",
        "name_prefix": "Miss",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AR",
            "license": "12044989",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "ANDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.