Active NPI
Madelene Bangalan Marcon, BCBA
- Behavior Analyst
- Bryant, AR
National Provider Identifier
1457125452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-23-66077
- Practice address
- 908 N Reynolds Rd
Bryant, AR 72022-3034 - Phone
- (501) 847-9711
- Fax
- (501) 847-6929
- NPI assigned
- Nov 9, 2023
- 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 | 1-23-66077 | AR | Primary |
Addresses
Primary practice location
908 N Reynolds Rd
Bryant, AR 72022-3034
Mailing address
P.O. Drawer 2109
Russellville, AR 72811-2109
Phone (479) 967-2322
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": "1699488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699488000000",
"number": "1457125452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. DRAWER 2109",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728112109",
"telephone_number": "479-967-2322",
"fax_number": "479-967-2876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "908 N REYNOLDS RD",
"city": "BRYANT",
"state": "AR",
"postal_code": "720223034",
"telephone_number": "501-847-9711",
"fax_number": "501-847-6929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCON",
"first_name": "MADELENE",
"middle_name": "BANGALAN",
"name_prefix": "Mrs.",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-09",
"last_updated": "2023-11-09",
"certification_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AR",
"license": "1-23-66077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryant, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.