Individual provider Active NPI

Kimberlee Danielle Rider, MS, BCBA, LBA

  • Behavior Analyst
  • Pelham, AL
National Provider Identifier
1477052397
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2017-082 Issued in AL
Practice address
1051 Oak Mountain Dr
Pelham, AL 35124-1324
Phone
(205) 582-8895
Fax
(205) 319-1922
NPI assigned
Feb 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 2017-082 AL Primary

Addresses

Primary practice location

1051 Oak Mountain Dr
Pelham, AL 35124-1324

Mailing address

1051 Oak Mountain Dr
Pelham, AL 35124-1324
Phone (205) 582-8895

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kim.rider@freedomtherapies.net

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2017-082ALMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Therapies, Inc. Behavior Analyst CurrentSince Jun 9, 2024 Accepting new patients

Locations

1051 Oak Mountain Dr
Pelham, AL 35124
Phone (205) 358-7311

Organizations & group practices 1

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": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1477052397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 OAK MOUNTAIN DR",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351241324",
            "telephone_number": "205-582-8895",
            "fax_number": "205-319-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 OAK MOUNTAIN DR",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351241324",
            "telephone_number": "205-582-8895",
            "fax_number": "205-319-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDER",
        "first_name": "KIMBERLEE",
        "middle_name": "DANIELLE",
        "name_prefix": "Miss",
        "credential": "MS, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AL",
            "license": "2017-082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kim.rider@freedomtherapies.net",
            "affiliation": "N",
            "endpointDescription": "HIPAA Email",
            "address_1": "1051 Oak Mountain Dr",
            "city": "Pelham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "351241324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pelham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.