Active NPI
Hayley Rose Dettenmayer
- Behavior Analyst
- Columbia, SC
National Provider Identifier
1396463881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1505 Blanding St
Columbia, SC 29201-2906 - Phone
- (803) 929-0011
- NPI assigned
- Aug 19, 2022
- Last updated
- Aug 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | NU | Primary |
Addresses
Primary practice location
1505 Blanding St
Columbia, SC 29201-2906
Mailing address
1505 Blanding St
Columbia, SC 29201-2906
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R58524248 | Other | NC | BLUE CROSS BLUE SHIELD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1396463881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 BLANDING ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292012906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 BLANDING ST",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292012906",
"telephone_number": "803-929-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DETTENMAYER",
"first_name": "HAYLEY",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-19",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "R58524248",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.