Individual provider Active NPI

Alexis Nichole Boglio, BCBA

  • Behavior Analyst
  • Phoenix, AZ
National Provider Identifier
1386932754
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1118830 Issued in AZ
Practice address
300 N 18TH St
Phoenix, AZ 85006-4103
Phone
(602) 218-8198
Fax
(602) 606-9803
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1118830 AZ Primary

Addresses

Primary practice location

300 N 18TH St
Phoenix, AZ 85006-4103

Mailing address

300 N 18TH St
Phoenix, AZ 85006-4103
Phone (602) 218-8198

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
1118830AZMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Autism Research and Resource Center Behavior Analyst 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": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1386932754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N 18TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850064103",
            "telephone_number": "602-218-8198",
            "fax_number": "602-606-9803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N 18TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850064103",
            "telephone_number": "602-218-8198",
            "fax_number": "602-606-9803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGLIO",
        "first_name": "ALEXIS",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "1118830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; 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.