Active NPI
Mason Keck
- Behavior Technician
- Nixa, MO
National Provider Identifier
1447097910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-258228
- Practice address
- 116 W Sherman Way Ste 1
Nixa, MO 65714-9022 - Phone
- (417) 298-0984
- Fax
- (417) 374-7185
- NPI assigned
- Jul 11, 2024
- 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 Technician | 106S00000X | RBT-23-258228 | MO | Primary |
Addresses
Primary practice location
116 W Sherman Way Ste 1
Nixa, MO 65714-9022
Mailing address
3126 E Valley Watermill Rd
Appt 1013
Springfield, MO 65803
Phone (417) 793-7599
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
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-23-258228 | MO | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daytastic ABA, LLC | Current | Accepting new patients |
Locations
116 W Sherman Way
Ste 1
Nixa, MO 65714
Phone (417) 298-0984
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.
-
- Behavior Analyst
- Nixa, MO
- NPI 1801473533
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1447097910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3126 E VALLEY WATERMILL RD",
"address_2": "APPT 1013",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "65803",
"telephone_number": "417-793-7599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "116 W SHERMAN WAY STE 1",
"city": "NIXA",
"state": "MO",
"postal_code": "657149022",
"telephone_number": "417-298-0984",
"fax_number": "417-374-7185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KECK",
"first_name": "MASON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-11",
"last_updated": "2024-07-11",
"certification_date": "2024-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MO",
"license": "RBT-23-258228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nixa, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.