Individual provider Active NPI

Mackenzie Goodspeed

  • Behavior Analyst
  • Memphis, TN
National Provider Identifier
1396582342
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-73622 Issued in TN
Practice address
721 W Brookhaven Cir
Memphis, TN 38117-4503
Phone
(901) 567-5361
NPI assigned
Jul 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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 1-24-73622 TN Primary

Addresses

Primary practice location

721 W Brookhaven Cir
Memphis, TN 38117-4503

Mailing address

592 Elkstone PL W Apt 202
Collierville, TN 38017-4285
Phone (731) 695-4282

Other practice location 1

6655 Quince Rd Ste 101
Memphis, TN 38119-8031
Phone (901) 567-5361

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": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1396582342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "592 ELKSTONE PL W APT 202",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380174285",
            "telephone_number": "731-695-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W BROOKHAVEN CIR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174503",
            "telephone_number": "901-567-5361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6655 Quince Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381198031",
            "country_code": "US",
            "telephone_number": "901-567-5361",
            "fax_number": "901-321-5257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODSPEED",
        "first_name": "MACKENZIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "1-24-73622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.