Individual provider Active NPI

Kristin Mumpower, LPA, BCBA

  • Behavior Analyst
  • Apex, NC
National Provider Identifier
1508202912
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-13-13055
Practice address
512 Kellyridge Dr
Apex, NC 27502-9531
Phone
(910) 228-3091
Fax
(910) 516-1682
NPI assigned
May 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-13-13055 Primary

Addresses

Primary practice location

512 Kellyridge Dr
Apex, NC 27502-9531

Mailing address

512 Kellyridge Dr
Apex, NC 27502-9531
Phone (910) 228-3091

Other names 1

  • Kristin Wilkinson Yonkers Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4583NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lighthouse ABA, PLLC Behavior Analyst CurrentSince Jul 24, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1508202912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 KELLYRIDGE DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275029531",
            "telephone_number": "910-228-3091",
            "fax_number": "910-516-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 KELLYRIDGE DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275029531",
            "telephone_number": "910-228-3091",
            "fax_number": "910-516-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMPOWER",
        "first_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "LPA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-13",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-13-13055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "YONKERS",
            "middle_name": "WILKINSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Apex, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.