NPIMap

Organization Active NPI

Momentum ABA Therapy

  • Behavior Analyst
  • Memphis, TN
National Provider Identifier
1407358609
Registry record updated Mar 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
11725115
Legal business name
MOMENTUM ABA THERAPY
Practice address
2125 Leichester LN
Memphis, TN 38134-6971
Phone
(901) 314-9722
NPI assigned
Mar 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2018

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

Authorized official

Name
April Acosta, NCBANPI 1366975120
Title
Owner
Phone
(901) 314-9722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X 11725115 Primary

Addresses

Primary practice location

2125 Leichester LN
Memphis, TN 38134-6971

Mailing address

2125 Leichester LN
Memphis, TN 38134-6971
Phone (901) 314-9722

Other identifiers 1

IdentifierTypeStateIssuer
Q034006MedicaidTN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520035200000",
    "number": "1407358609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 LEICHESTER LN",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381346971",
            "telephone_number": "901-314-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 LEICHESTER LN",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381346971",
            "telephone_number": "901-314-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM ABA THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-03",
        "last_updated": "2018-03-03",
        "status": "A",
        "authorized_official_last_name": "ACOSTA",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-314-9722",
        "authorized_official_credential": "NCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "11725115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q034006",
            "state": "TN"
        }
    ],
    "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 Mar 3, 2018; 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.