Active NPI
Michael Parker Edmondson
- Assistant Behavior Analyst
- Portland, OR
National Provider Identifier
1508105693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assistant Behavior Analyst
- License
- ABA-AB-10194178
- Practice address
- 121 SW Salmon St FL 11
Portland, OR 97204-2908 - Phone
- (855) 832-6727
- NPI assigned
- Feb 8, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | ABA-AB-10194178 | OR | Primary |
Addresses
Primary practice location
121 SW Salmon St FL 11
Portland, OR 97204-2908
Mailing address
7108 S Kanner Hwy
Stuart, FL 34997-7462
Phone (855) 832-6727
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 |
|---|---|---|---|
| ABA-AB-10194178 | OR | MD | Assistant Behavior Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavior Analysts, Inc. | Behavior Analyst | Past | Accepting new patients |
| Behavior Analysts, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Behavior Analyst
- Walnut Creek, CA
- NPI 1457780504
-
- Community/Behavioral Health Agency
- Walnut Creek, CA
- NPI 1548595085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661299200000",
"number": "1508105693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 S KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462",
"telephone_number": "855-832-6727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 SW SALMON ST FL 11",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972042908",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMONDSON",
"first_name": "MICHAEL",
"middle_name": "PARKER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-08",
"last_updated": "2022-08-24",
"certification_date": "2022-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "106E00000X",
"taxonomy_group": "",
"desc": "Assistant Behavior Analyst",
"state": "OR",
"license": "ABA-AB-10194178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.