Mikki B Coburn, MED

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-20-43590 Issued in IN

Practice address

160 Plainfield Village Drive, Suite 101
Null
Plainfield, IN 46168-2782

Phone

(463) 888-0118

Fax

(317) 520-8200

NPI assigned

Aug 13, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mikki Zimmerman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

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.

• Hopebridge, LLC

  • Child & Adolescent Psychiatry Physician
  • Kokomo, IN
  • NPI 1891820668

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1447861497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BLVD STE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "317-939-5377",
            "fax_number": "317-932-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 PLAINFIELD VILLAGE DRIVE, SUITE 101",
            "address_2": "NULL",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461682782",
            "telephone_number": "463-888-0118",
            "fax_number": "317-520-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 S Park Blvd Ste 21",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "IN",
            "postal_code": "461438838",
            "country_code": "US",
            "telephone_number": "317-449-2104",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6925 Parkdale Pl",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462544673",
            "country_code": "US",
            "telephone_number": "317-597-4553",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11450 N Meridian St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460324688",
            "country_code": "US",
            "telephone_number": "317-689-7850",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9769 Crosspoint Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462563346",
            "country_code": "US",
            "telephone_number": "317-588-2732",
            "fax_number": "317-520-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBURN",
        "first_name": "MIKKI",
        "middle_name": "B",
        "credential": "MED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IN",
            "license": "1-20-43590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB CERTIFICATION",
            "identifier": "1-20-43590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKKI",
            "last_name": "ZIMMERMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kymberly Clark
• Sarah Kay Clark, NP
• Sherry Clark, RBT
• Wigena Clervil
• Trinity Coates, RBT
• Geoffrey T Coker, NP
• Alyssa Colagrossi, RBT
• Lauren Colip, PHARMD
• Lily Colter, RBT
• Adrianna Contreras, RBT

• Behavior Analyst in Plainfield, IN
• Providers in Plainfield, IN by specialty
• Behavior Analyst in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.