McKenzie Davis – Behavior Technician

Key facts

NPI: 1487250668
Entity type: Individual (NPI type 1)
Primary specialty: Behavior Technician 106S00000X
Practice address: 3435 W 96TH St
Indianapolis, IN 46268-1102
Phone: (317) 802-7447
Fax: (317) 802-7325
NPI assigned: Dec 11, 2020
Sex: Female
Sole proprietor: No

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.

Access Behavioral Health Solutions Behavior Analyst · Indianapolis, IN · NPI 1114348703

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Access Behavioral Health Solutions		Current since Dec 13, 2020	Accepting new patients

Locations

3435 W 96th St
Indianapolis, IN 46268
Phone (317) 802-7447

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Behavior Technician	106S00000X			Yes

Addresses

Primary practice location

3435 W 96TH St
Indianapolis, IN 46268-1102

Mailing address

3435 W 96TH St
Indianapolis, IN 46268-1102
Phone (317) 802-7447

Electronic endpoints

Type	Endpoint	Use	Affiliation
Other URL	mdavis@accessba.com	Direct	Access Behavioral Health Solutions

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 11, 2020.

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1487250668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 W 96TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681102",
            "telephone_number": "317-802-7447",
            "fax_number": "317-802-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 W 96TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462681102",
            "telephone_number": "317-802-7447",
            "fax_number": "317-802-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mdavis@accessba.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Access Behavioral Health Solutions",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3435 W 96th St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462681102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

All providers in Indianapolis, IN · Behavior Technician in Indiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.