Individual provider Active NPI

Tamiko Teague, BCBA

  • Behavior Analyst
  • Chapel Hill, NC
National Provider Identifier
1386289056
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-35674 Issued in IN
Practice address
50101 Governors Dr Ste 170
Chapel Hill, NC 27517-9257
Phone
(984) 254-5650
Fax
(317) 520-8200
NPI assigned
Nov 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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 11935674 CA
Behavior Analyst 103K00000X 1-19-35674 IN Primary

Addresses

Primary practice location

50101 Governors Dr Ste 170
Chapel Hill, NC 27517-9257

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other practice location 1

8350 Archibald Ave Ste 110
Rancho Cucamonga, CA 91730-3670
Phone (858) 264-5858

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
11935674CAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Hopebridge LLC Past Accepting new patients

Organizations & group practices 1

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": "1573862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1386289056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "317-520-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50101 GOVERNORS DR STE 170",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275179257",
            "telephone_number": "984-254-5650",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8350 Archibald Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917303670",
            "country_code": "US",
            "telephone_number": "858-264-5858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "TAMIKO",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-16",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "11935674",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-19-35674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.