Individual provider Active NPI

Madison Marie Hunnings

  • Behavior Technician
  • Chesapeake, VA
National Provider Identifier
1508454588
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
648 Independence Pkwy Ste 300
Chesapeake, VA 23320-5208
Phone
(757) 776-0790
NPI assigned
Jan 6, 2021
Last updated
Jan 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X NU Primary

Addresses

Primary practice location

648 Independence Pkwy Ste 300
Chesapeake, VA 23320-5208

Mailing address

1115 Hillside Ave Apt 4
Norfolk, VA 23503-2073
Phone (757) 405-4979

Other practice location 1

1115 Hillside Ave Apt 4
Norfolk, VA 23503-2073
Phone (757) 405-4979

Other identifiers 1

IdentifierTypeStateIssuer
810187660035MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL n/a Other

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
Your Life ABA VA, LLC PastSince Jan 10, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1508454588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 HILLSIDE AVE APT 4",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235032073",
            "telephone_number": "757-405-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 INDEPENDENCE PKWY STE 300",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205208",
            "telephone_number": "757-776-0790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 Hillside Ave Apt 4",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235032073",
            "country_code": "US",
            "telephone_number": "757-405-4979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUNNINGS",
        "first_name": "MADISON",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "810187660035",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "n/a",
            "address_1": "648 Independence Pkwy Ste 300",
            "city": "Chesapeake",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233205208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.