NPIMap

Individual provider Active NPI

Mackenzie Kathleen Thompson

  • Behavior Technician
  • Ankeny, IA
National Provider Identifier
1467052175
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
106S00000X Issued in IA
Practice address
1555 SE Delaware Ave Ste O
Ankeny, IA 50021-4011
Phone
(515) 261-2402
NPI assigned
Oct 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 106S00000X IA Primary

Addresses

Primary practice location

1555 SE Delaware Ave Ste O
Ankeny, IA 50021-4011

Mailing address

1555 SE Delaware Ave Ste O
Ankeny, IA 50021-4011
Phone (515) 261-2402

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

LicenseStateTypeSpecialty
106S00000XIAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
KP Enterprises Iowa Behavior Technician PastSince Nov 1, 2020 Accepting new patients
KP Enterprises Iowa PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1467052175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SE DELAWARE AVE STE O",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500214011",
            "telephone_number": "515-261-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SE DELAWARE AVE STE O",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500214011",
            "telephone_number": "515-261-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MACKENZIE",
        "middle_name": "KATHLEEN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IA",
            "license": "106S00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ankeny, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.