Individual provider Active NPI

Rachel Katya Pankin, BCBA

  • Behavior Analyst
  • Silver Spring, MD
National Provider Identifier
1508385923
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2425 Blueridge Ave Apt 171
Silver Spring, MD 20902-4560
Phone
(757) 232-6986
NPI assigned
Sep 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X 0134000196 VA
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

2425 Blueridge Ave Apt 171
Silver Spring, MD 20902-4560

Mailing address

2425 Blueridge Ave Apt 171
Silver Spring, MD 20902-4560
Phone (757) 232-6986

Other practice location 1

2670 Penbury Ct Apt 202
Woodbridge, VA 22191-4237
Phone (757) 232-6986

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

LicenseStateTypeSpecialty
0134000196VAMDAssistant Behavior Analyst

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1508385923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 BLUERIDGE AVE APT 171",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209024560",
            "telephone_number": "757-232-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 BLUERIDGE AVE APT 171",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209024560",
            "telephone_number": "757-232-6986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2670 Penbury Ct Apt 202",
            "address_purpose": "LOCATION",
            "city": "Woodbridge",
            "state": "VA",
            "postal_code": "221914237",
            "country_code": "US",
            "telephone_number": "757-232-6986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANKIN",
        "first_name": "RACHEL",
        "middle_name": "KATYA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "VA",
            "license": "0134000196",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.