Active NPI
Amy Reynolds
- Behavior Analyst
- Exton, PA
National Provider Identifier
1477064137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BH003598
- Practice address
- 467 Creamery Way
Exton, PA 19341-2508 - Phone
- (610) 363-1488
- NPI assigned
- Oct 19, 2017
- 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 | BH003598 | PA | Primary |
Addresses
Primary practice location
467 Creamery Way
Exton, PA 19341-2508
Mailing address
414 5TH Ave
Parkesburg, PA 19365-1439
Phone (484) 712-5758
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007727350084 | Medicaid | PA |
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 |
|---|---|---|---|
| BH003598 | PA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508371200000",
"number": "1477064137",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 5TH AVE",
"city": "PARKESBURG",
"state": "PA",
"postal_code": "193651439",
"telephone_number": "484-712-5758",
"fax_number": "484-712-5758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "467 CREAMERY WAY",
"city": "EXTON",
"state": "PA",
"postal_code": "193412508",
"telephone_number": "610-363-1488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "AMY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-19",
"last_updated": "2017-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "BH003598",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007727350084",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Exton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.