Active NPI
Daniel Ervin, BCBA
- Behavior Analyst
- Normal, IL
National Provider Identifier
1518320795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1606 Hunt Dr
Normal, IL 61761-2192 - Phone
- (309) 451-8888
- Fax
- (309) 451-8989
- NPI assigned
- Apr 4, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1606 Hunt Dr
Normal, IL 61761-2192
Mailing address
1307 Heritage Rd E
Normal, IL 61761-1301
Phone (309) 532-2893
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifelong Access | Behavior Analyst | Past | 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": "1459728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459728000000",
"number": "1518320795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307 HERITAGE RD E",
"city": "NORMAL",
"state": "IL",
"postal_code": "617611301",
"telephone_number": "309-532-2893",
"fax_number": "309-451-8989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1606 HUNT DR",
"city": "NORMAL",
"state": "IL",
"postal_code": "617612192",
"telephone_number": "309-451-8888",
"fax_number": "309-451-8989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERVIN",
"first_name": "DANIEL",
"credential": "BCBA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-04",
"last_updated": "2016-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Normal, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.