Active NPI
Carolyn Wilson, BCBA
- Behavior Analyst
- Cookeville, TN
National Provider Identifier
1467942276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 18-32323
- Practice address
- 4519 Greenfield Dr
Cookeville, TN 38501-9480 - Phone
- (931) 261-0889
- NPI assigned
- May 16, 2018
- Last updated
- May 6, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 18-32323 | TN | |
| Behavior Analyst | 103K00000X | 18-32323 | Primary |
Addresses
Primary practice location
4519 Greenfield Dr
Cookeville, TN 38501-9480
Mailing address
4519 Greenfield Dr
Cookeville, TN 38501-9480
Phone (931) 261-0889
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RBT-17-32048 | Other | BACB |
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 |
|---|---|---|---|
| 18-32323 | TN | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centers of Development, PLLC | Past | Accepting new patients | |
| Acorn Health, LLC. | Behavior Analyst | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Occupational Therapist
- Cookeville, TN
- NPI 1770771602
-
- Behavior Analyst
- Coral Gables, FL
- NPI 1801494679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557100800000",
"number": "1467942276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4519 GREENFIELD DR",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385019480",
"telephone_number": "931-261-0889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4519 GREENFIELD DR",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385019480",
"telephone_number": "931-261-0889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CAROLYN",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-16",
"last_updated": "2019-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TN",
"license": "18-32323",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "18-32323",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BACB",
"identifier": "RBT-17-32048",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cookeville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.