Kathy Amiesys Bautista

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-18-50861 Issued in NU

Practice address

131 Johnson St Apt 6
Lynn, MA 01902-4030

Phone

(781) 584-9081

NPI assigned

Aug 11, 2017

Last updated

Apr 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1487179347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10722 OLD SYCAMORE LOOP",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346384988",
            "telephone_number": "781-584-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 JOHNSON ST APT 6",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019024030",
            "telephone_number": "781-584-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "KATHY",
        "middle_name": "AMIESYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": "RBT-18-50861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "452807522",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Behavior Technician in Lynn, MA
• Providers in Lynn, MA by specialty
• Behavior Technician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.