NPIMap

Individual provider Active NPI

Colin Lance Moore, BCBA

  • Behavior Analyst
  • Batavia, IL
National Provider Identifier
1508043183
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-14-0724 Issued in IL
Practice address
1133 W Wilson St Apt E
Batavia, IL 60510-1884
Phone
(812) 814-0182
Fax
(812) 814-0182
NPI assigned
Jan 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Intellectual & Developmental Disabilities Psychologist 103TM1800X
Psychoanalysis Psychologist 103TP0814X
Behavior Analyst 103K00000X 1-14-0724 IL Primary

Addresses

Primary practice location

1133 W Wilson St Apt E
Batavia, IL 60510-1884

Mailing address

1133 W Wilson St Apt E
Batavia, IL 60510-1884
Phone (812) 814-0182

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aspire ABA Services Inc PastSince Mar 30, 2025 Accepting new patients
Prolex Medical Services, Inc Past Accepting new patients
Aspire ABA Services Inc Behavior Analyst PastSince May 16, 2021 Accepting new patients

Organizations & group practices 3

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": "1201305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1508043183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 W WILSON ST APT E",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101884",
            "telephone_number": "812-814-0182",
            "fax_number": "423-296-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 W WILSON ST APT E",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101884",
            "telephone_number": "812-814-0182",
            "fax_number": "812-814-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "COLIN",
        "middle_name": "LANCE",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-26",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-14-0724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Batavia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.