McKenzie Gibson, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-24-376791 Issued in MO

Practice address

1218 Oak Borough Dr
Ballwin, MO 63021-8330

Phone

(636) 579-2250

Fax

(415) 406-3316

NPI assigned

Sep 24, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Ad Astra Autism Centers LLC

  • Behavior Analyst
  • Overland, MO
  • NPI 1710762760

  Behavior Technician

  NPD

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1467279182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 OAK BOROUGH DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630218330",
            "telephone_number": "636-579-2250",
            "fax_number": "415-406-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 OAK BOROUGH DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630218330",
            "telephone_number": "636-579-2250",
            "fax_number": "415-406-3316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MCKENZIE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MO",
            "license": "RBT-24-376791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rene Gassner, D.C.
• Gateway Little Smiles of Ballwin, LLC
• Seth Gerlach, D.C.
• Cole Gerstenberger, DPT
• Lynne Gibbs, D.C.
• Trent Conner Gibson
• Jennifer Sharon Giltner, FNP-C
• Ashleigh Ann Glass, PA-C
• Emmalene Faith Glover, DC
• Bradley Gloyeske, DC

• Behavior Technician in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Behavior Technician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.

Verify at the official NPI Registry.